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 $8.13 Median $14.79 Typical High $27.54 | Facility | None | $8.13 | $14.79 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $22.39 | Professional | None | $8.13 | $8.13 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.71 Median $19.05 Typical High $52.48 | Facility | None | $8.71 | $19.05 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | None | $8.13 | $8.13 | $10.96 |
Aultcare Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
CareSource Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
CareSource Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $10.00 | Professional | None | $7.59 | $7.59 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $17.38 Typical High $26.92 | Facility | None | $15.49 | $17.38 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.77 | Professional | None | $8.13 | $8.13 | $9.77 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3.55 Median $15.49 Typical High $33.88 | Facility | None | $3.55 | $15.49 | $33.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.77 | Professional | None | $8.13 | $8.13 | $9.77 |
Molina Setting Professional Modifier None Typical Low $7.24 Median $7.94 Typical High $10.23 | Professional | None | $7.24 | $7.94 | $10.23 |
SummaCare Setting Professional Modifier None Typical Low $8.13 Median $8.51 Typical High $10.00 | Professional | None | $8.13 | $8.51 | $10.00 |
United Setting Professional Modifier None Typical Low $6.46 Median $7.24 Typical High $7.76 | Professional | None | $6.46 | $7.24 | $7.76 |
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 $4.07 Median $4.07 Typical High $4.57 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.82 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.38 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.91 |
Where Ohio sits
Rates are fairly even across states for this service. 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· 34th of 51
$8.13
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.