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 $72.44 Median $165.96 Typical High $302.00 | Facility | None | $72.44 | $165.96 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $204.17 | Professional | None | $60.26 | $60.26 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $91.20 Typical High $173.78 | Facility | None | $60.26 | $91.20 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $85.11 | Professional | None | $60.26 | $60.26 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
CareSource Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | None | $47.86 | $47.86 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $128.82 Typical High $194.98 | Facility | None | $51.29 | $128.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | None | $60.26 | $60.26 | $74.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $51.29 Median $128.82 Typical High $177.83 | Facility | None | $51.29 | $128.82 | $177.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | None | $60.26 | $60.26 | $74.13 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $75.86 | Professional | None | $51.29 | $61.66 | $75.86 |
SummaCare Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $74.13 | Professional | None | $60.26 | $63.10 | $74.13 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $63.10 | Professional | None | $51.29 | $60.26 | $63.10 |
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 $30.20 Median $30.20 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | 53 · Discontinued | $12.02 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.61 |
Where Ohio sits
The same service costs 2.0 times more in Wyoming than in Hawaii. 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· 14th of 51
$60.26
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.