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 $245.47 Median $676.08 Typical High $831.76 | Facility | None | $245.47 | $676.08 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $478.63 | Professional | None | $245.47 | $245.47 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $645.65 | Facility | None | $257.04 | $416.87 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $323.59 | Professional | None | $181.97 | $213.80 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $575.44 Typical High $776.25 | Facility | None | $257.04 | $575.44 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | None | $269.15 | $269.15 | $316.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $257.04 Median $575.44 Typical High $776.25 | Facility | None | $257.04 | $575.44 | $776.25 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | None | $269.15 | $269.15 | $316.23 |
Molina Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,862.09 | $1,862.09 | $2,187.76 |
SummaCare Setting Facility Modifier None Typical Low $281.84 Median $295.12 Typical High $331.13 | Facility | None | $281.84 | $295.12 | $331.13 |
SummaCare Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $346.74 | Professional | None | $263.03 | $281.84 | $346.74 |
United Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $309.03 | Professional | None | $234.42 | $257.04 | $309.03 |
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 $123.03 Median $123.03 Typical High $239.88 | Professional | 52 · Reduced service | $123.03 | $123.03 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $95.50 | Professional | 53 · Discontinued | $48.98 | $48.98 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $72.44 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $47.86 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $47.86 |
Where Ohio sits
The same service costs 1.7 times more in Alaska than in Indiana. 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· 43rd of 51
$257
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.