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 $2,818.38 Median $4,677.35 Typical High $7,244.36 | Facility | None | $2,818.38 | $4,677.35 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $6,025.60 | Professional | None | $2,137.96 | $2,398.83 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $3,715.35 Typical High $6,606.93 | Facility | None | $2,290.87 | $3,715.35 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,905.46 | $2,137.96 | $3,548.13 |
Aultcare Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
CareSource Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $4,677.35 Typical High $7,079.46 | Facility | None | $4,073.80 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,454.71 | Professional | None | $2,137.96 | $2,137.96 | $2,454.71 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3,715.35 Median $4,677.35 Typical High $6,165.95 | Facility | None | $3,715.35 | $4,677.35 | $6,165.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,454.71 | Professional | None | $2,137.96 | $2,137.96 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $3,090.30 | Professional | None | $2,344.23 | $2,691.53 | $3,090.30 |
SummaCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,398.83 | $4,265.80 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,162.28 | Professional | None | $2,137.96 | $2,137.96 | $3,162.28 |
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 $1,071.52 Median $1,071.52 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $812.83 | Professional | 53 · Discontinued | $436.52 | $436.52 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $602.56 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $407.38 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $407.38 |
Where Ohio sits
The same service costs 2.0 times more in Arizona than in Alabama. 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· 3rd of 51
$2,754
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.