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 $208.93 Typical High $794.33 | Facility | None | $208.93 | $208.93 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $602.56 | Professional | None | $208.93 | $208.93 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $630.96 | Facility | None | $223.87 | $331.13 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $389.05 | Professional | None | $208.93 | $208.93 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $457.09 Typical High $691.83 | Facility | None | $398.11 | $457.09 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | None | $208.93 | $208.93 | $245.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $295.12 Median $457.09 Typical High $602.56 | Facility | None | $295.12 | $457.09 | $602.56 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | None | $208.93 | $208.93 | $245.47 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $302.00 | Professional | None | $229.09 | $263.03 | $302.00 |
SummaCare Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $416.87 | Professional | None | $208.93 | $234.42 | $416.87 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $309.03 | Professional | None | $208.93 | $208.93 | $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 $104.71 Median $104.71 Typical High $302.00 | Professional | 52 · Reduced service | $104.71 | $104.71 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $120.23 | Professional | 53 · Discontinued | $42.66 | $42.66 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $91.20 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $60.26 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $60.26 |
Where Ohio sits
The same service costs 1.6 times more in Arizona than in New Jersey. 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
$251
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.