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 $229.09 Median $229.09 Typical High $275.42 | Facility | None | $229.09 | $229.09 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $309.03 | Professional | None | $229.09 | $229.09 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $218.78 | Professional | None | $120.23 | $120.23 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $524.81 Typical High $1,479.11 | Facility | None | $245.47 | $524.81 | $1,479.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $354.81 | Professional | None | $194.98 | $229.09 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $724.44 | Facility | None | $549.54 | $549.54 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $269.15 | Professional | None | $251.19 | $251.19 | $269.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $724.44 | Facility | None | $549.54 | $549.54 | $724.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | None | $239.88 | $251.19 | $251.19 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $501.19 | Professional | None | $338.84 | $426.58 | $501.19 |
SummaCare Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $478.63 | Professional | None | $251.19 | $263.03 | $478.63 |
United Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $316.23 | Professional | None | $223.87 | $269.15 | $316.23 |
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 $114.82 Median $114.82 Typical High $138.04 | Professional | 52 · Reduced service | $114.82 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $56.23 | Professional | 53 · Discontinued | $45.71 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $27.54 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $27.54 |
Where Ohio sits
The same service costs 2.0 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· 20th of 51
$251
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.