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 $1,023.29 Median $1,023.29 Typical High $1,698.24 | Facility | None | $1,023.29 | $1,023.29 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,023.29 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $2,511.89 Typical High $6,918.31 | Facility | None | $1,148.15 | $2,511.89 | $6,918.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $1,122.02 | Professional | None | $407.38 | $407.38 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,162.28 | Facility | None | $2,344.23 | $2,344.23 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,096.48 | $1,288.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,162.28 | Facility | None | $2,344.23 | $2,344.23 | $3,162.28 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,096.48 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $602.56 | Professional | None | $457.09 | $512.86 | $602.56 |
SummaCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,258.93 | $2,238.72 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,071.52 | $1,584.89 |
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 $512.86 Median $512.86 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $257.04 | Professional | 53 · Discontinued | $204.17 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $190.55 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $128.82 |
Where Ohio sits
The same service costs 8.3 times more in Arizona than in Montana. 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· 44th of 51
$1,023
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.