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 $79.43 Median $380.19 Typical High $11,220.18 | Facility | None | $79.43 | $380.19 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $199.53 Typical High $512.86 | Professional | None | $42.66 | $199.53 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $18,620.87 | Facility | None | $16,595.87 | $16,595.87 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $147.91 Typical High $316.23 | Professional | None | $39.81 | $147.91 | $316.23 |
Aultcare Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $47.86 | Professional | None | $43.65 | $43.65 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $144.54 Typical High $309.03 | Professional | None | $42.66 | $144.54 | $309.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $32.36 Median $407.38 Typical High $1,174.90 | Facility | None | $32.36 | $407.38 | $1,174.90 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $42.66 Median $112.20 Typical High $295.12 | Professional | None | $42.66 | $112.20 | $295.12 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $331.13 | Professional | None | $169.82 | $234.42 | $331.13 |
SummaCare Setting Professional Modifier None Typical Low $38.90 Median $199.53 Typical High $263.03 | Professional | None | $38.90 | $199.53 | $263.03 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,445.44 Typical High $3,715.35 | Facility | None | $478.63 | $1,445.44 | $3,715.35 |
United Setting Professional Modifier None Typical Low $45.71 Median $186.21 Typical High $338.84 | Professional | None | $45.71 | $186.21 | $338.84 |
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 $21.38 Median $100.00 Typical High $125.89 | Professional | 52 · Reduced service | $21.38 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $39.81 Typical High $50.12 | Professional | 53 · Discontinued | $8.71 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $30.20 Typical High $37.15 | Professional | 55 · Aftercare only | $6.46 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $19.95 Typical High $25.12 | Professional | 56 · Pre-op care only | $4.27 | $19.95 | $25.12 |
Where Ohio sits
The same service costs 5.2 times more in North Carolina 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· 25th of 51
$186
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.