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 $169.82 Median $446.68 Typical High $575.44 | Facility | None | $169.82 | $446.68 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $467.74 | Professional | None | $169.82 | $169.82 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $524.81 | Facility | None | $177.83 | $288.40 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $363.08 | Professional | None | $177.83 | $199.53 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Facility | None | $467.74 | $467.74 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | None | $218.78 | $218.78 | $234.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Facility | None | $467.74 | $467.74 | $630.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | None | $218.78 | $218.78 | $234.42 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $239.88 | Professional | None | $181.97 | $213.80 | $239.88 |
SummaCare Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $338.84 | Professional | None | $177.83 | $186.21 | $338.84 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $234.42 | Facility | None | $199.53 | $199.53 | $234.42 |
United Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $234.42 | Professional | None | $165.96 | $208.93 | $234.42 |
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 $85.11 Median $85.11 Typical High $234.42 | Professional | 52 · Reduced service | $85.11 | $85.11 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $93.33 | Professional | 53 · Discontinued | $33.88 | $33.88 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $70.79 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $46.77 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $46.77 |
Where Ohio sits
The same service costs 1.8 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· 18th of 51
$219
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.