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 $239.88 Median $436.52 Typical High $812.83 | Facility | None | $239.88 | $436.52 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $660.69 | Professional | None | $239.88 | $275.42 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $549.54 Typical High $1,513.56 | Facility | None | $257.04 | $549.54 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $371.54 | Professional | None | $204.17 | $239.88 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $758.58 | Facility | None | $562.34 | $562.34 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | None | $263.03 | $263.03 | $281.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $67.61 Median $457.09 Typical High $758.58 | Facility | None | $67.61 | $457.09 | $758.58 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | None | $263.03 | $263.03 | $316.23 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $524.81 | Professional | None | $208.93 | $316.23 | $524.81 |
SummaCare Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $512.86 | Professional | None | $269.15 | $275.42 | $512.86 |
United Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $302.00 | Professional | None | $213.80 | $275.42 | $302.00 |
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 $120.23 Median $120.23 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $69.18 | Professional | 53 · Discontinued | $47.86 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $51.29 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $33.88 |
Where Ohio sits
The same service costs 2.1 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· 9th of 51
$263
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.