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 $295.12 Median $380.19 Typical High $446.68 | Facility | None | $295.12 | $380.19 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $446.68 | Professional | None | $295.12 | $371.54 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $467.74 | Professional | None | $257.04 | $346.74 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $524.81 | Professional | None | $288.40 | $389.05 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Molina Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $776.25 | Professional | None | $407.38 | $501.19 | $776.25 |
Optum Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
SummaCare Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $588.84 | Professional | None | $354.81 | $436.52 | $588.84 |
United Setting Facility Modifier None Typical Low $363.08 Median $426.58 Typical High $602.56 | Facility | None | $363.08 | $426.58 | $602.56 |
United Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $549.54 | Professional | None | $251.19 | $346.74 | $549.54 |
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 $194.98 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $87.10 Typical High $89.13 | Professional | 53 · Discontinued | $77.62 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $43.65 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $43.65 | $44.67 |
Where Ohio sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 33rd of 51
$389
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.