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 $120.23 Median $120.23 Typical High $467.74 | Facility | None | $120.23 | $120.23 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $354.81 | Professional | None | $120.23 | $120.23 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $208.93 Typical High $371.54 | Facility | None | $131.83 | $208.93 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $229.09 | Professional | None | $120.23 | $120.23 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $257.04 Typical High $398.11 | Facility | None | $229.09 | $257.04 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | None | $120.23 | $120.23 | $138.04 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $346.74 | Facility | None | $169.82 | $257.04 | $346.74 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | None | $120.23 | $120.23 | $138.04 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $173.78 | Professional | None | $131.83 | $151.36 | $173.78 |
SummaCare Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $239.88 | Professional | None | $120.23 | $131.83 | $239.88 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $177.83 | Professional | None | $120.23 | $120.23 | $177.83 |
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 $60.26 Median $60.26 Typical High $177.83 | Professional | 52 · Reduced service | $60.26 | $60.26 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $70.79 | Professional | 53 · Discontinued | $23.99 | $23.99 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $53.70 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $35.48 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $35.48 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 5th of 51
$151
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.