How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $26.92 Median $89.13 Typical High $177.83 | Facility | None | $26.92 | $89.13 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $30.90 Typical High $177.83 | Professional | None | $26.92 | $30.90 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $42.66 Typical High $81.28 | Facility | None | $28.84 | $42.66 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $56.23 | Professional | None | $26.92 | $26.92 | $56.23 |
Aultcare Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
CareSource Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $57.54 Typical High $85.11 | Facility | None | $48.98 | $57.54 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $91.20 | Professional | None | $26.92 | $26.92 | $91.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $48.98 Median $57.54 Typical High $75.86 | Facility | None | $48.98 | $57.54 | $75.86 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $91.20 | Professional | None | $26.92 | $26.92 | $91.20 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $34.67 Typical High $38.90 | Professional | None | $29.51 | $34.67 | $38.90 |
SummaCare Setting Professional Modifier None Typical Low $28.18 Median $29.51 Typical High $52.48 | Professional | None | $28.18 | $29.51 | $52.48 |
United Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $39.81 | Professional | None | $26.92 | $26.92 | $39.81 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $13.18 Typical High $67.61 | Professional | 52 · Reduced service | $13.18 | $13.18 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $26.92 | Professional | 53 · Discontinued | $5.37 | $5.37 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $20.42 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $13.49 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $13.49 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | JZ · No drug discarded | $22.91 | $22.91 | $22.91 |
Where Ohio sits
The same service costs 2.9 times more in Wyoming than in Minnesota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 11th of 51
$33.88
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.