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 $263.03 Median $724.44 Typical High $891.25 | Facility | None | $263.03 | $724.44 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $602.56 Typical High $1,659.59 | Facility | None | $275.42 | $602.56 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $398.11 | Professional | None | $223.87 | $263.03 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Facility | None | $616.60 | $616.60 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $309.03 | Professional | None | $288.40 | $288.40 | $309.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Facility | None | $616.60 | $616.60 | $831.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $309.03 | Professional | None | $288.40 | $288.40 | $309.03 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $50.12 | Professional | None | $39.81 | $50.12 | $50.12 |
SummaCare Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $537.03 | Professional | None | $288.40 | $302.00 | $537.03 |
United Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $363.08 | Professional | None | $257.04 | $309.03 | $363.08 |
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 $131.83 Median $131.83 Typical High $181.97 | Professional | 52 · Reduced service | $131.83 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | 53 · Discontinued | $52.48 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $36.31 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $36.31 |
Where Ohio sits
The same service costs 3.9 times more in Arizona than in Montana. 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· 16th of 51
$288
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.