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 $173.78 Median $251.19 Typical High $575.44 | Facility | None | $173.78 | $251.19 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $467.74 | Professional | None | $173.78 | $173.78 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $371.54 Typical High $1,122.02 | Facility | None | $138.04 | $371.54 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $257.04 | Professional | None | $114.82 | $173.78 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
CareSource Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $371.54 Typical High $575.44 | Facility | None | $323.59 | $371.54 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $173.78 Median $371.54 Typical High $489.78 | Facility | None | $173.78 | $371.54 | $489.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | None | $147.91 | $173.78 | $173.78 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $114.82 Typical High $239.88 | Professional | None | $25.12 | $114.82 | $239.88 |
SummaCare Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $346.74 | Professional | None | $173.78 | $190.55 | $346.74 |
United Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $134.90 | Professional | None | $91.20 | $91.20 | $134.90 |
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 $87.10 Median $87.10 Typical High $234.42 | Professional | 52 · Reduced service | $87.10 | $87.10 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $93.33 | Professional | 53 · Discontinued | $34.67 | $34.67 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $70.79 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $46.77 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $46.77 |
Where Ohio sits
The same service costs 3.2 times more in Wyoming than in Oklahoma. 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· 26th of 51
$174
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.