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 $1,905.46 Median $1,905.46 Typical High $9,772.37 | Facility | None | $1,905.46 | $1,905.46 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $7,413.10 | Professional | None | $1,905.46 | $1,905.46 | $7,413.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $5,754.40 | Facility | None | $1,995.26 | $3,235.94 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $3,981.07 | Professional | None | $1,862.09 | $1,905.46 | $3,981.07 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $4,073.80 Typical High $6,309.57 | Facility | None | $3,630.78 | $4,073.80 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,905.46 | $1,905.46 | $3,801.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $5,495.41 | Facility | None | $3,467.37 | $4,073.80 | $5,495.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,905.46 | $1,905.46 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,691.53 | Professional | None | $2,041.74 | $2,398.83 | $2,691.53 |
SummaCare Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,089.30 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,862.09 | $1,862.09 | $2,754.23 |
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 $954.99 Median $954.99 Typical High $3,715.35 | Professional | 52 · Reduced service | $954.99 | $954.99 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $1,479.11 | Professional | 53 · Discontinued | $380.19 | $380.19 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $1,122.02 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $741.31 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $741.31 |
Where Ohio sits
The same service costs 2.3 times more in Texas than in Maryland. 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· 9th of 51
$2,291
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.