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 $269.15 Median $446.68 Typical High $489.78 | Facility | None | $269.15 | $446.68 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $489.78 | Professional | None | $269.15 | $288.40 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $436.52 Typical High $676.08 | Facility | None | $269.15 | $436.52 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $489.78 | Professional | None | $245.47 | $245.47 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $776.25 | Facility | None | $575.44 | $575.44 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | None | $269.15 | $269.15 | $288.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $776.25 | Facility | None | $575.44 | $575.44 | $776.25 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | None | $269.15 | $269.15 | $288.40 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $389.05 | Professional | None | $295.12 | $338.84 | $389.05 |
SummaCare Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $537.03 | Professional | None | $281.84 | $295.12 | $537.03 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $288.40 | Facility | None | $245.47 | $245.47 | $288.40 |
United Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $338.84 | Professional | None | $239.88 | $288.40 | $338.84 |
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 $134.90 Median $134.90 Typical High $199.53 | Professional | 52 · Reduced service | $134.90 | $134.90 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $81.28 | Professional | 53 · Discontinued | $53.70 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $60.26 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $40.74 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $40.74 |
Where Ohio sits
The same service costs 2.3 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· 6th of 51
$295
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.