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 $63.10 Median $63.10 Typical High $128.82 | Facility | None | $63.10 | $63.10 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $125.89 | Professional | None | $63.10 | $63.10 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $107.15 Typical High $190.55 | Facility | None | $67.61 | $107.15 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $114.82 | Professional | None | $53.70 | $63.10 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $134.90 Typical High $204.17 | Facility | None | $61.66 | $134.90 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $61.66 Median $134.90 Typical High $177.83 | Facility | None | $61.66 | $134.90 | $177.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $89.13 | Professional | None | $67.61 | $77.62 | $89.13 |
SummaCare Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $123.03 | Professional | None | $63.10 | $69.18 | $123.03 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $134.90 | Professional | None | $61.66 | $69.18 | $134.90 |
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 $30.90 Median $30.90 Typical High $63.10 | Professional | 52 · Reduced service | $30.90 | $30.90 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $25.12 | Professional | 53 · Discontinued | $12.59 | $12.59 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $18.62 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $12.59 |
Where Ohio sits
The same service costs 9.3 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· 9th of 51
$70.79
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.