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 $181.97 Median $331.13 Typical High $602.56 | Facility | None | $181.97 | $331.13 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $501.19 | Professional | None | $181.97 | $213.80 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $416.87 Typical High $1,148.15 | Facility | None | $190.55 | $416.87 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $281.84 | Professional | None | $154.88 | $181.97 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $575.44 | Facility | None | $426.58 | $426.58 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | None | $199.53 | $199.53 | $213.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $56.23 Median $426.58 Typical High $562.34 | Facility | None | $56.23 | $426.58 | $562.34 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | None | $199.53 | $199.53 | $213.80 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $245.47 | Professional | None | $162.18 | $208.93 | $245.47 |
SummaCare Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $371.54 | Professional | None | $194.98 | $204.17 | $371.54 |
United Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $245.47 | Professional | None | $173.78 | $213.80 | $245.47 |
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 $26.92 Median $26.92 Typical High $41.69 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $27.54 |
Where Ohio sits
The same service costs 562.3 times more in Montana 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· 15th of 51
$200
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.