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 $229.09 Median $630.96 Typical High $758.58 | Facility | None | $229.09 | $630.96 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | None | $229.09 | $229.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $354.81 Typical High $676.08 | Facility | None | $239.88 | $354.81 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $426.58 | Professional | None | $229.09 | $229.09 | $426.58 |
Aultcare Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $489.78 Typical High $741.31 | Facility | None | $426.58 | $489.78 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $316.23 Median $489.78 Typical High $645.65 | Facility | None | $316.23 | $489.78 | $645.65 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $323.59 | Professional | None | $245.47 | $281.84 | $323.59 |
SummaCare Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $446.68 | Professional | None | $229.09 | $251.19 | $446.68 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $331.13 | Professional | None | $223.87 | $223.87 | $331.13 |
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 $112.20 Median $112.20 Typical High $229.09 | Professional | 52 · Reduced service | $112.20 | $112.20 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | 53 · Discontinued | $45.71 | $45.71 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $69.18 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $45.71 |
Where Ohio sits
The same service costs 1.6 times more in Arizona than in Mississippi. 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
$282
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.