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 $30.90 Median $85.11 Typical High $104.71 | Facility | None | $30.90 | $85.11 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $72.44 | Professional | None | $30.90 | $30.90 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.20 Median $44.67 Typical High $87.10 | Facility | None | $30.20 | $44.67 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $64.57 | Professional | None | $30.90 | $30.90 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
CareSource Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $66.07 Typical High $100.00 | Facility | None | $57.54 | $66.07 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $60.26 | Professional | None | $30.90 | $30.90 | $60.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $51.29 Median $66.07 Typical High $89.13 | Facility | None | $51.29 | $66.07 | $89.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $60.26 | Professional | None | $30.90 | $30.90 | $60.26 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $34.67 Typical High $67.61 | Professional | None | $29.51 | $34.67 | $67.61 |
SummaCare Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $61.66 | Professional | None | $32.36 | $33.88 | $61.66 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | None | $36.31 | $36.31 | $41.69 |
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 $15.49 Median $15.49 Typical High $36.31 | Professional | 52 · Reduced service | $15.49 | $15.49 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $14.45 | Professional | 53 · Discontinued | $6.17 | $6.17 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $10.96 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $7.24 |
Where Ohio sits
The same service costs 1.9 times more in Texas than in Tennessee. 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· 18th of 51
$36.31
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.