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 $338.84 Median $630.96 Typical High $1,148.15 | Facility | None | $338.84 | $630.96 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $933.25 | Professional | None | $338.84 | $407.38 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $407.38 | Professional | None | $229.09 | $331.13 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $338.84 Median $549.54 Typical High $1,023.29 | Facility | None | $338.84 | $549.54 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $537.03 | Professional | None | $302.00 | $302.00 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $1,023.29 | Facility | None | $758.58 | $758.58 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $380.19 | Professional | None | $354.81 | $354.81 | $380.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $245.47 Median $758.58 Typical High $1,023.29 | Facility | None | $245.47 | $758.58 | $1,023.29 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | None | $331.13 | $354.81 | $354.81 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $478.63 | Professional | None | $346.74 | $426.58 | $478.63 |
SummaCare Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $676.08 | Professional | None | $354.81 | $371.54 | $676.08 |
United Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $380.19 | Facility | None | $323.59 | $323.59 | $380.19 |
United Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $416.87 | Professional | None | $316.23 | $380.19 | $416.87 |
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 $169.82 Median $169.82 Typical High $331.13 | Professional | 52 · Reduced service | $169.82 | $169.82 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $131.83 | Professional | 53 · Discontinued | $67.61 | $67.61 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $97.72 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $66.07 |
Where Ohio sits
The same service costs 2.9 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· 5th of 51
$389
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.