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 $67.61 Median $186.21 Typical High $302.00 | Facility | None | $67.61 | $186.21 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $302.00 | Professional | None | $67.61 | $67.61 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $117.49 Typical High $204.17 | Facility | None | $72.44 | $117.49 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $141.25 | Professional | None | $67.61 | $67.61 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $144.54 Typical High $218.78 | Facility | None | $125.89 | $144.54 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | None | $67.61 | $67.61 | $91.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $128.82 Median $144.54 Typical High $194.98 | Facility | None | $128.82 | $144.54 | $194.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | None | $67.61 | $67.61 | $69.18 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $144.54 | Professional | None | $95.50 | $134.90 | $144.54 |
SummaCare Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $131.83 | Professional | None | $67.61 | $74.13 | $131.83 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $100.00 | Professional | None | $67.61 | $67.61 | $100.00 |
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 $33.11 Median $33.11 Typical High $151.36 | Professional | 52 · Reduced service | $33.11 | $33.11 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $60.26 | Professional | 53 · Discontinued | $13.49 | $13.49 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $45.71 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $30.20 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $30.20 |
Where Ohio sits
The same service costs 2.0 times more in Oklahoma than in New Mexico. 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· 9th of 51
$85.11
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.