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 $102.33 Median $190.55 Typical High $346.74 | Facility | None | $102.33 | $190.55 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $281.84 | Professional | None | $102.33 | $123.03 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | None | $83.18 | $83.18 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $229.09 Typical High $630.96 | Facility | None | $107.15 | $229.09 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $186.21 | Professional | None | $85.11 | $100.00 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $316.23 | Facility | None | $234.42 | $234.42 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $117.49 | Professional | None | $109.65 | $109.65 | $117.49 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $33.88 Median $234.42 Typical High $316.23 | Facility | None | $33.88 | $234.42 | $316.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | None | $109.65 | $109.65 | $112.20 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $213.80 | Professional | None | $112.20 | $154.88 | $213.80 |
SummaCare Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $208.93 | Professional | None | $91.20 | $109.65 | $208.93 |
United Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $134.90 | Professional | None | $97.72 | $117.49 | $134.90 |
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 $51.29 Median $51.29 Typical High $85.11 | Professional | 52 · Reduced service | $51.29 | $51.29 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $33.88 | Professional | 53 · Discontinued | $20.42 | $20.42 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $25.70 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $16.98 |
Where Ohio sits
The same service costs 3.6 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· 22nd of 51
$110
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.