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 $15.85 Median $15.85 Typical High $512.86 | Facility | None | $15.85 | $15.85 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $190.55 | Professional | None | $15.85 | $15.85 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,621.81 Typical High $4,073.80 | Facility | None | $776.25 | $1,621.81 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $323.59 | Professional | None | $181.97 | $213.80 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $380.19 Typical High $676.08 | Professional | None | $30.20 | $380.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $22.91 Typical High $199.53 | Professional | None | $18.20 | $22.91 | $199.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $70.79 | Professional | None | $50.12 | $60.26 | $70.79 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,122.02 Typical High $3,715.35 | Facility | None | $316.23 | $1,122.02 | $3,715.35 |
United Setting Professional Modifier None Typical Low $13.49 Median $17.38 Typical High $38.90 | Professional | None | $13.49 | $17.38 | $38.90 |
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 $7.94 Median $7.94 Typical High $95.50 | Professional | 52 · Reduced service | $7.94 | $7.94 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $38.02 | Professional | 53 · Discontinued | $3.24 | $3.24 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $28.84 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $19.05 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $19.05 |
Where Ohio sits
The same service costs 19.1 times more in Indiana than in Delaware. 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· 2nd of 51
$214
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.