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 $40.74 Median $74.13 Typical High $112.20 | Facility | None | $40.74 | $74.13 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $109.65 | Professional | None | $40.74 | $50.12 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $47.86 | Professional | None | $33.88 | $40.74 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $93.33 Typical High $263.03 | Facility | None | $43.65 | $93.33 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $85.11 | Professional | None | $43.65 | $51.29 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $162.18 | Facility | None | $75.86 | $120.23 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Professional | None | $56.23 | $56.23 | $60.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $38.90 Median $87.10 Typical High $165.96 | Facility | None | $38.90 | $87.10 | $165.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | None | $50.12 | $56.23 | $56.23 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $81.28 | Professional | None | $48.98 | $57.54 | $81.28 |
SummaCare Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
SummaCare Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $79.43 | Professional | None | $42.66 | $53.70 | $79.43 |
United Setting Professional Modifier None Typical Low $50.12 Median $58.88 Typical High $69.18 | Professional | None | $50.12 | $58.88 | $69.18 |
2 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 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $15.14 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $10.00 |
Where Ohio sits
The same service costs 2.0 times more in Minnesota 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· 12th of 51
$56.23
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.