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 $194.98 Median $363.08 Typical High $660.69 | Facility | None | $194.98 | $363.08 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $537.03 | Professional | None | $194.98 | $234.42 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $446.68 Typical High $1,258.93 | Facility | None | $208.93 | $446.68 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $346.74 | Professional | None | $165.96 | $194.98 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $204.17 Typical High $380.19 | Facility | None | $54.95 | $204.17 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $616.60 | Facility | None | $467.74 | $467.74 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | None | $213.80 | $213.80 | $229.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $54.95 Median $467.74 Typical High $616.60 | Facility | None | $54.95 | $467.74 | $616.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | None | $213.80 | $213.80 | $218.78 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $389.05 | Professional | None | $213.80 | $275.42 | $389.05 |
SummaCare Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $426.58 | Professional | None | $158.49 | $223.87 | $426.58 |
United Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $269.15 | Professional | None | $190.55 | $229.09 | $269.15 |
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 $97.72 Median $97.72 Typical High $158.49 | Professional | 52 · Reduced service | $97.72 | $97.72 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $63.10 | Professional | 53 · Discontinued | $38.90 | $38.90 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $46.77 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $31.62 |
Where Ohio sits
The same service costs 549.5 times more in Arizona than in Rhode Island. 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· 14th of 51
$214
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.