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 $199.53 Median $295.12 Typical High $1,000.00 | Facility | None | $199.53 | $295.12 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $467.74 | Professional | None | $295.12 | $295.12 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $380.19 Typical High $724.44 | Facility | None | $234.42 | $380.19 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $489.78 | Professional | None | $251.19 | $295.12 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $630.96 Typical High $977.24 | Facility | None | $562.34 | $630.96 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $537.03 | Professional | None | $295.12 | $295.12 | $537.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $851.14 | Facility | None | $407.38 | $630.96 | $851.14 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $537.03 | Professional | None | $295.12 | $295.12 | $537.03 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $478.63 | Professional | None | $269.15 | $371.54 | $478.63 |
SummaCare Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $588.84 | Professional | None | $295.12 | $323.59 | $588.84 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $316.23 | Professional | None | $213.80 | $213.80 | $316.23 |
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 $147.91 Median $147.91 Typical High $234.42 | Professional | 52 · Reduced service | $147.91 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $93.33 | Professional | 53 · Discontinued | $58.88 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $70.79 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $46.77 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $46.77 |
Where Ohio sits
The same service costs 6.8 times more in Wyoming 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· 11th of 51
$309
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.