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 $3,890.45 Median $8,317.64 Typical High $13,182.57 | Facility | None | $3,890.45 | $8,317.64 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $7,244.36 | Professional | None | $3,890.45 | $3,890.45 | $7,244.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $6,165.95 Typical High $11,748.98 | Facility | None | $4,168.69 | $6,165.95 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $6,165.95 | Professional | None | $3,311.31 | $3,890.45 | $6,165.95 |
CareSource Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $8,511.38 Typical High $12,882.50 | Facility | None | $7,413.10 | $8,511.38 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $4,786.30 | Professional | None | $3,890.45 | $3,890.45 | $4,786.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7,244.36 Median $8,511.38 Typical High $11,220.18 | Facility | None | $7,244.36 | $8,511.38 | $11,220.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $4,786.30 | Professional | None | $3,890.45 | $3,890.45 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $4,168.69 Median $4,897.79 Typical High $5,495.41 | Professional | None | $4,168.69 | $4,897.79 | $5,495.41 |
SummaCare Setting Professional Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $7,762.47 | Professional | None | $3,890.45 | $4,365.16 | $7,762.47 |
United Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
United Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $5,623.41 | Professional | None | $3,801.89 | $3,801.89 | $5,623.41 |
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 $1,949.84 Median $1,949.84 Typical High $3,630.78 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $1,445.44 | Professional | 53 · Discontinued | $794.33 | $794.33 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $1,096.48 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $724.44 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $724.44 |
Where Ohio sits
The same service costs 11.0 times more in Alabama 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
$4,786
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.