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 $346.74 Median $446.68 Typical High $1,202.26 | Facility | None | $346.74 | $446.68 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $1,202.26 | Professional | None | $346.74 | $446.68 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $741.31 | Professional | None | $398.11 | $562.34 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $1,318.26 Typical High $16,595.87 | Facility | None | $426.58 | $1,318.26 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $851.14 | Professional | None | $380.19 | $549.54 | $851.14 |
CareSource Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $724.44 | Professional | None | $630.96 | $676.08 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,290.87 Typical High $2,691.53 | Facility | None | $524.81 | $2,290.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $933.25 | Professional | None | $354.81 | $478.63 | $933.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $524.81 Median $2,290.87 Typical High $2,691.53 | Facility | None | $524.81 | $2,290.87 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $933.25 | Professional | None | $354.81 | $478.63 | $933.25 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $933.25 | Professional | None | $446.68 | $691.83 | $933.25 |
SummaCare Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $870.96 | Professional | None | $354.81 | $524.81 | $870.96 |
United Setting Facility Modifier None Typical Low $371.54 Median $870.96 Typical High $4,677.35 | Facility | None | $371.54 | $870.96 | $4,677.35 |
United Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $891.25 | Professional | None | $323.59 | $467.74 | $891.25 |
3 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 $173.78 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $173.78 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $34.67 | $44.67 | $50.12 |
Where Ohio sits
The same service costs 3.1 times more in Alaska than in Indiana. 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
$550
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.