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 $79.43 Median $104.71 Typical High $288.40 | Facility | None | $79.43 | $104.71 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $85.11 Typical High $141.25 | Professional | None | $30.90 | $85.11 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $107.15 | Professional | None | $75.86 | $75.86 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $102.33 Typical High $190.55 | Professional | None | $34.67 | $102.33 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $33.88 | Professional | None | $29.51 | $29.51 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $67.61 Typical High $114.82 | Professional | None | $27.54 | $67.61 | $114.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $27.54 Median $67.61 Typical High $114.82 | Professional | None | $27.54 | $67.61 | $114.82 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $158.49 | Professional | None | $79.43 | $100.00 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $24.55 Median $32.36 Typical High $97.72 | Professional | None | $24.55 | $32.36 | $97.72 |
United Setting Facility Modifier None Typical Low $147.91 Median $173.78 Typical High $245.47 | Facility | None | $147.91 | $173.78 | $245.47 |
United Setting Professional Modifier None Typical Low $25.70 Median $58.88 Typical High $120.23 | Professional | None | $25.70 | $58.88 | $120.23 |
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 $15.49 Median $38.90 Typical High $43.65 | Professional | 52 · Reduced service | $15.49 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $15.49 Typical High $17.38 | Professional | 53 · Discontinued | $6.17 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $11.75 Typical High $12.88 | Professional | 55 · Aftercare only | $4.57 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $7.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.09 | $7.76 | $8.71 |
Where Ohio sits
The same service costs 3.6 times more in North Carolina than in Washington, DC. 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· 27th of 51
$79.43
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.