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 $20.89 Median $57.54 Typical High $83.18 | Facility | None | $20.89 | $57.54 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $28.18 | Professional | None | $20.89 | $20.89 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $29.51 Median $45.71 Typical High $74.13 | Facility | None | $29.51 | $45.71 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $33.11 | Professional | None | $20.89 | $20.89 | $33.11 |
CareSource Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
CareSource Setting Professional Modifier None Typical Low $13.80 Median $19.05 Typical High $25.70 | Professional | None | $13.80 | $19.05 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $44.67 Typical High $69.18 | Facility | None | $27.54 | $44.67 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $26.30 | Professional | None | $20.89 | $20.89 | $26.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $27.54 Median $48.98 Typical High $173.78 | Facility | None | $27.54 | $48.98 | $173.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $43.65 | Professional | None | $20.89 | $20.89 | $43.65 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $29.51 Typical High $35.48 | Professional | None | $20.89 | $29.51 | $35.48 |
SummaCare Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $25.70 | Professional | None | $20.89 | $21.88 | $25.70 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $33.88 | Professional | None | $27.54 | $31.62 | $33.88 |
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 $10.47 Median $10.47 Typical High $12.59 | Professional | 52 · Reduced service | $10.47 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $5.01 | Professional | 53 · Discontinued | $4.17 | $4.17 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.80 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.51 |
Where Ohio sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 38th of 51
$20.89
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.