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 $245.47 Median $245.47 Typical High $691.83 | Facility | None | $245.47 | $245.47 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $691.83 | Professional | None | $245.47 | $245.47 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $426.58 Typical High $741.31 | Facility | None | $263.03 | $426.58 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $457.09 | Professional | None | $208.93 | $245.47 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $1,148.15 | Facility | None | $457.09 | $794.33 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $426.58 | Professional | None | $398.11 | $398.11 | $426.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $1,148.15 | Facility | None | $457.09 | $851.14 | $1,148.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $426.58 | Professional | None | $398.11 | $398.11 | $426.58 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $354.81 | Professional | None | $269.15 | $302.00 | $354.81 |
SummaCare Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $478.63 | Professional | None | $257.04 | $269.15 | $478.63 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $426.58 | Professional | None | $239.88 | $309.03 | $426.58 |
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 $120.23 Median $120.23 Typical High $346.74 | Professional | 52 · Reduced service | $120.23 | $120.23 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $138.04 | Professional | 53 · Discontinued | $48.98 | $48.98 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $104.71 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $69.18 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $69.18 |
Where Ohio sits
The same service costs 8.7 times more in Alabama than in Rhode Island. 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· 16th of 51
$339
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.