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 $67.61 Median $186.21 Typical High $223.87 | Facility | None | $67.61 | $186.21 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $741.31 | Professional | None | $67.61 | $67.61 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $138.04 Typical High $229.09 | Facility | None | $79.43 | $138.04 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $134.90 | Professional | None | $67.61 | $67.61 | $134.90 |
Aultcare Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $144.54 Typical High $194.98 | Facility | None | $100.00 | $144.54 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $208.93 | Professional | None | $67.61 | $67.61 | $208.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $323.59 | Facility | None | $100.00 | $158.49 | $323.59 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $208.93 | Professional | None | $67.61 | $67.61 | $208.93 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $138.04 | Professional | None | $83.18 | $100.00 | $138.04 |
SummaCare Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $134.90 | Professional | None | $70.79 | $74.13 | $134.90 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $169.82 | Professional | None | $79.43 | $89.13 | $169.82 |
4 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 $33.88 Median $33.88 Typical High $371.54 | Professional | 52 · Reduced service | $33.88 | $33.88 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $147.91 | Professional | 53 · Discontinued | $13.49 | $13.49 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $112.20 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $74.13 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $74.13 |
Where Ohio sits
The same service costs 2.7 times more in South Carolina than in Georgia. 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
$95.50
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.