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 $128.82 Median $354.81 Typical High $436.52 | Facility | None | $128.82 | $354.81 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $398.11 | Professional | None | $128.82 | $128.82 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $208.93 Typical High $323.59 | Facility | None | $131.83 | $208.93 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $245.47 | Professional | None | $128.82 | $128.82 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $281.84 Typical High $426.58 | Facility | None | $245.47 | $281.84 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | None | $128.82 | $128.82 | $147.91 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $245.47 Median $281.84 Typical High $371.54 | Facility | None | $245.47 | $281.84 | $371.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | None | $128.82 | $128.82 | $147.91 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $186.21 | Professional | None | $141.25 | $162.18 | $186.21 |
SummaCare Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $257.04 | Professional | None | $128.82 | $144.54 | $257.04 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $190.55 | Professional | None | $128.82 | $128.82 | $190.55 |
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 $64.57 Median $64.57 Typical High $199.53 | Professional | 52 · Reduced service | $64.57 | $64.57 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $81.28 | Professional | 53 · Discontinued | $25.70 | $25.70 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $60.26 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $39.81 |
Where Ohio sits
The same service costs 1.6 times more in Texas than in North Carolina. 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
$158
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.