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 $123.03 Median $229.09 Typical High $346.74 | Facility | None | $123.03 | $229.09 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $89.13 Typical High $281.84 | Professional | None | $83.18 | $89.13 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,570.88 | Facility | None | $524.81 | $1,174.90 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $239.88 | Professional | None | $114.82 | $177.83 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,089.30 | Facility | None | $1,621.81 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,659.59 Typical High $2,630.27 | Facility | None | $398.11 | $1,659.59 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $263.03 | Professional | None | $102.33 | $114.82 | $263.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $1,659.59 Typical High $2,570.40 | Facility | None | $398.11 | $1,659.59 | $2,570.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $269.15 | Professional | None | $102.33 | $112.20 | $269.15 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $223.87 | Professional | None | $128.82 | $165.96 | $223.87 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Facility | None | $891.25 | $933.25 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $147.91 | Professional | None | $97.72 | $97.72 | $147.91 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $234.42 | Professional | None | $93.33 | $114.82 | $234.42 |
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 $41.69 Median $41.69 Typical High $61.66 | Professional | 52 · Reduced service | $41.69 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $24.55 | Professional | 53 · Discontinued | $16.60 | $16.60 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $18.62 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $12.30 |
Where Ohio sits
The same service costs 7.9 times more in Kansas than in New York. 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· 21st of 51
$174
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.