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 $398.11 Median $630.96 Typical High $741.31 | Facility | None | $398.11 | $630.96 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $537.03 | Professional | None | $398.11 | $398.11 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $691.83 Typical High $1,230.27 | Facility | None | $426.58 | $691.83 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $630.96 | Professional | None | $338.84 | $398.11 | $630.96 |
Aultcare Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $870.96 Typical High $1,318.26 | Facility | None | $758.58 | $870.96 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $467.74 | Professional | None | $398.11 | $398.11 | $467.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $870.96 Typical High $1,148.15 | Facility | None | $741.31 | $870.96 | $1,148.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $467.74 | Professional | None | $398.11 | $398.11 | $467.74 |
Molina Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $562.34 | Professional | None | $426.58 | $501.19 | $562.34 |
SummaCare Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $794.33 | Professional | None | $398.11 | $446.68 | $794.33 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | None | $389.05 | $389.05 | $575.44 |
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 $199.53 Median $199.53 Typical High $263.03 | Professional | 52 · Reduced service | $199.53 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | 53 · Discontinued | $79.43 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $53.70 |
Where Ohio sits
The same service costs 2.8 times more in Arizona than in Alabama. 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· 7th of 51
$468
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.