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 $389.05 Median $954.99 Typical High $1,318.26 | Facility | None | $389.05 | $954.99 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $660.69 | Professional | None | $389.05 | $389.05 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $660.69 Typical High $1,174.90 | Facility | None | $416.87 | $660.69 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $660.69 | Professional | None | $331.13 | $389.05 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $831.76 Typical High $1,288.25 | Facility | None | $380.19 | $831.76 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $380.19 Median $831.76 Typical High $1,122.02 | Facility | None | $380.19 | $831.76 | $1,122.02 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
Molina Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $549.54 | Professional | None | $426.58 | $489.78 | $549.54 |
SummaCare Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $776.25 | Professional | None | $389.05 | $426.58 | $776.25 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $831.76 | Professional | None | $380.19 | $426.58 | $831.76 |
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 $194.98 Median $194.98 Typical High $331.13 | Professional | 52 · Reduced service | $194.98 | $194.98 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $131.83 | Professional | 53 · Discontinued | $77.62 | $77.62 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $97.72 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $66.07 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $66.07 |
Where Ohio sits
The same service costs 11.5 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· 7th of 51
$468
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.