How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $794.33 Median $794.33 Typical High $1,584.89 | Facility | None | $794.33 | $794.33 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $707.95 | Professional | None | $398.11 | $478.63 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $79,432.82 | Facility | None | $776.25 | $776.25 | $79,432.82 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | None | $851.14 | $851.14 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,202.26 | Professional | None | $691.83 | $691.83 | $1,202.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,202.26 | Professional | None | $691.83 | $691.83 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $512.86 | Professional | None | $239.88 | $346.74 | $512.86 |
SummaCare Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | None | $501.19 | $501.19 | $588.84 |
United Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $851.14 | Professional | None | $389.05 | $549.54 | $851.14 |
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 $398.11 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $93.33 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Arkansas. 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· 44th of 51
$646
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.