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 $16.22 Median $44.67 Typical High $91.20 | Facility | None | $16.22 | $44.67 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $91.20 | Professional | None | $16.22 | $17.78 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.79 Median $21.88 Typical High $43.65 | Facility | None | $14.79 | $21.88 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $16.22 Typical High $28.18 | Professional | None | $15.14 | $16.22 | $28.18 |
CareSource Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
CareSource Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $34.67 Typical High $46.77 | Facility | None | $13.18 | $34.67 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $85.11 | Professional | None | $16.22 | $16.22 | $85.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $16.22 Median $34.67 Typical High $83.18 | Facility | None | $16.22 | $34.67 | $83.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $85.11 | Professional | None | $16.22 | $16.22 | $85.11 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $18.62 Typical High $22.39 | Professional | None | $15.14 | $18.62 | $22.39 |
SummaCare Setting Professional Modifier None Typical Low $16.98 Median $17.78 Typical High $32.36 | Professional | None | $16.98 | $17.78 | $32.36 |
United Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $29.51 | Professional | None | $13.80 | $15.14 | $29.51 |
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 $8.13 Median $8.13 Typical High $64.57 | Professional | 52 · Reduced service | $8.13 | $8.13 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $69.18 | Professional | 53 · Discontinued | $3.24 | $3.24 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $51.29 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $34.67 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $34.67 |
Where Ohio sits
The same service costs 5.9 times more in Wyoming than in North Dakota. 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· 12th of 51
$18.20
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.