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 $208.93 Median $575.44 Typical High $707.95 | Facility | None | $208.93 | $575.44 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $707.95 | Professional | None | $208.93 | $208.93 | $707.95 |
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 Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $295.12 | Professional | None | $151.36 | $177.83 | $295.12 |
Aultcare Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | None | $181.97 | $181.97 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $331.13 | Professional | None | $169.82 | $218.78 | $331.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $323.59 | Professional | None | $169.82 | $186.21 | $323.59 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $316.23 | Professional | None | $165.96 | $218.78 | $316.23 |
SummaCare Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $275.42 | Professional | None | $208.93 | $208.93 | $275.42 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $478.63 | Professional | None | $151.36 | $218.78 | $478.63 |
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 $104.71 Median $104.71 Typical High $380.19 | Professional | 52 · Reduced service | $104.71 | $104.71 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $151.36 | Professional | 53 · Discontinued | $41.69 | $41.69 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $112.20 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $75.86 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $75.86 |
Where Ohio sits
The same service costs 3.0 times more in Wisconsin than in Florida. 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· 46th of 51
$209
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.