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 $234.42 Median $616.60 Typical High $776.25 | Facility | None | $234.42 | $616.60 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $676.08 | Professional | None | $234.42 | $269.15 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $363.08 Typical High $691.83 | Facility | None | $245.47 | $363.08 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $426.58 | Professional | None | $234.42 | $234.42 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $501.19 Typical High $776.25 | Facility | None | $436.52 | $501.19 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | None | $234.42 | $234.42 | $275.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $229.09 Median $501.19 Typical High $660.69 | Facility | None | $229.09 | $501.19 | $660.69 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $288.40 | Professional | None | $234.42 | $234.42 | $288.40 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $331.13 | Professional | None | $251.19 | $288.40 | $331.13 |
SummaCare Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $467.74 | Professional | None | $234.42 | $257.04 | $467.74 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $338.84 | Professional | None | $229.09 | $229.09 | $338.84 |
2 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 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $97.72 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $66.07 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $66.07 |
Where Ohio sits
The same service costs 1.6 times more in Arizona than in Hawaii. 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· 4th of 51
$282
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.