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 $154.88 Median $154.88 Typical High $562.34 | Facility | None | $154.88 | $154.88 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $426.58 | Professional | None | $154.88 | $154.88 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $371.54 Typical High $1,047.13 | Facility | None | $173.78 | $371.54 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $302.00 | Professional | None | $158.49 | $158.49 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $354.81 Typical High $467.74 | Facility | None | $162.18 | $354.81 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | None | $162.18 | $162.18 | $190.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $162.18 Median $354.81 Typical High $467.74 | Facility | None | $162.18 | $354.81 | $467.74 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | None | $162.18 | $162.18 | $190.55 |
SummaCare Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $338.84 | Professional | None | $169.82 | $186.21 | $338.84 |
United Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $239.88 | Professional | None | $158.49 | $158.49 | $239.88 |
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 $77.62 Median $77.62 Typical High $213.80 | Professional | 52 · Reduced service | $77.62 | $77.62 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $85.11 | Professional | 53 · Discontinued | $30.90 | $30.90 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $64.57 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $42.66 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $42.66 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in Texas. 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· 27th of 51
$162
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.