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 $83.18 Median $229.09 Typical High $281.84 | Facility | None | $83.18 | $229.09 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $245.47 | Professional | None | $83.18 | $83.18 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $141.25 Typical High $257.04 | Facility | None | $87.10 | $141.25 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $154.88 | Professional | None | $83.18 | $83.18 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $181.97 Typical High $275.42 | Facility | None | $158.49 | $181.97 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | None | $83.18 | $83.18 | $97.72 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $114.82 Median $181.97 Typical High $239.88 | Facility | None | $114.82 | $181.97 | $239.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | None | $83.18 | $83.18 | $97.72 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $117.49 | Professional | None | $89.13 | $104.71 | $117.49 |
SummaCare Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $165.96 | Professional | None | $83.18 | $93.33 | $165.96 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $120.23 | Professional | None | $81.28 | $81.28 | $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 $41.69 Median $41.69 Typical High $123.03 | Professional | 52 · Reduced service | $41.69 | $41.69 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $48.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $37.15 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $24.55 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $24.55 |
Where Ohio sits
The same service costs 1.5 times more in Arizona than in Nebraska. 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· 3rd of 51
$102
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.