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 $645.65 Median $812.83 Typical High $1,778.28 | Facility | None | $645.65 | $812.83 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $2,137.96 | Professional | None | $645.65 | $812.83 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,258.93 | Professional | None | $724.44 | $933.25 | $1,258.93 |
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 $645.65 Median $954.99 Typical High $1,513.56 | Professional | None | $645.65 | $954.99 | $1,513.56 |
CareSource Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,230.27 | $1,318.26 |
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 $616.60 Median $870.96 Typical High $1,698.24 | Professional | None | $616.60 | $870.96 | $1,698.24 |
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 $616.60 Median $870.96 Typical High $1,698.24 | Professional | None | $616.60 | $870.96 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,698.24 | Professional | None | $977.24 | $1,288.25 | $1,698.24 |
SummaCare Setting Professional Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,621.81 | Professional | None | $630.96 | $1,047.13 | $1,621.81 |
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 $575.44 Median $851.14 Typical High $1,621.81 | Professional | None | $575.44 | $851.14 | $1,621.81 |
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 $323.59 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $323.59 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $95.50 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $64.57 | $81.28 | $91.20 |
Where Ohio sits
The same service costs 3.2 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· 30th of 51
$977
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.