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 $512.86 Median $1,412.54 Typical High $1,949.84 | Facility | None | $512.86 | $1,412.54 | $1,949.84 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,949.84 | Professional | None | $512.86 | $512.86 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,548.82 | Facility | None | $537.03 | $870.96 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $977.24 | Professional | None | $512.86 | $512.86 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,698.24 | Facility | None | $954.99 | $1,096.48 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | None | $512.86 | $512.86 | $575.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,479.11 | Facility | None | $933.25 | $1,096.48 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | None | $512.86 | $512.86 | $575.44 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $724.44 | Professional | None | $549.54 | $645.65 | $724.44 |
SummaCare Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $1,023.29 | Professional | None | $512.86 | $562.34 | $1,023.29 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $741.31 | Professional | None | $501.19 | $501.19 | $741.31 |
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 $257.04 Median $257.04 Typical High $977.24 | Professional | 52 · Reduced service | $257.04 | $257.04 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $389.05 | Professional | 53 · Discontinued | $102.33 | $102.33 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $295.12 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $194.98 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $194.98 |
Where Ohio sits
The same service costs 2.8 times more in Arizona than in Oklahoma. 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· 4th of 51
$617
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.