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 $194.98 Median $194.98 Typical High $398.11 | Facility | None | $194.98 | $194.98 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $398.11 | Professional | None | $194.98 | $194.98 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $446.68 Typical High $1,230.27 | Facility | None | $204.17 | $446.68 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $371.54 | Professional | None | $186.21 | $186.21 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $457.09 Typical High $602.56 | Facility | None | $204.17 | $457.09 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | None | $213.80 | $213.80 | $229.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $204.17 Median $457.09 Typical High $602.56 | Facility | None | $204.17 | $457.09 | $602.56 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | None | $213.80 | $213.80 | $229.09 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $229.09 | Professional | None | $181.97 | $204.17 | $229.09 |
SummaCare Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $398.11 | Professional | None | $208.93 | $218.78 | $398.11 |
United Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $229.09 | Facility | None | $194.98 | $194.98 | $229.09 |
United Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $263.03 | Professional | None | $190.55 | $229.09 | $263.03 |
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 $95.50 Median $95.50 Typical High $199.53 | Professional | 52 · Reduced service | $95.50 | $95.50 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $79.43 | Professional | 53 · Discontinued | $38.90 | $38.90 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $60.26 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $39.81 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $39.81 |
Where Ohio sits
The same service costs 1.9 times more in Arizona than in Alabama. 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· 8th of 51
$214
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.