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 $87.10 Median $87.10 Typical High $436.52 | Facility | None | $87.10 | $87.10 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $239.88 | Professional | None | $87.10 | $87.10 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $199.53 Typical High $549.54 | Facility | None | $93.33 | $199.53 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $181.97 | Professional | None | $91.20 | $114.82 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Facility | None | $204.17 | $204.17 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | None | $95.50 | $95.50 | $102.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Facility | None | $204.17 | $204.17 | $275.42 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $125.89 | Professional | None | $95.50 | $95.50 | $125.89 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $239.88 | Professional | None | $158.49 | $223.87 | $239.88 |
SummaCare Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $181.97 | Professional | None | $95.50 | $100.00 | $181.97 |
United Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $131.83 | Professional | None | $85.11 | $109.65 | $131.83 |
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 $43.65 Median $43.65 Typical High $120.23 | Professional | 52 · Reduced service | $43.65 | $43.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $47.86 | Professional | 53 · Discontinued | $17.38 | $17.38 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $35.48 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $23.99 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $23.99 |
Where Ohio sits
The same service costs 1.7 times more in Texas than in Arkansas. 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· 7th of 51
$115
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.