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 $776.25 Median $1,412.54 Typical High $4,897.79 | Facility | None | $776.25 | $1,412.54 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $4,677.35 | Professional | None | $776.25 | $776.25 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $870.96 Median $1,862.09 Typical High $5,248.07 | Facility | None | $870.96 | $1,862.09 | $5,248.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,698.24 | Professional | None | $977.24 | $1,148.15 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,344.23 | Facility | None | $1,737.80 | $1,737.80 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | None | $812.83 | $812.83 | $954.99 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,344.23 | Facility | None | $1,737.80 | $1,737.80 | $2,344.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | None | $812.83 | $812.83 | $954.99 |
Molina Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,412.54 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,698.24 | Professional | None | $851.14 | $933.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,174.90 | Professional | None | $794.33 | $794.33 | $1,174.90 |
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 $380.19 Median $380.19 Typical High $2,344.23 | Professional | 52 · Reduced service | $380.19 | $380.19 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $933.25 | Professional | 53 · Discontinued | $154.88 | $154.88 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $707.95 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $467.74 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $467.74 |
Where Ohio sits
The same service costs 2.6 times more in Alabama than in Florida. 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· 13th of 51
$1,148
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.