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 $69.18 Median $114.82 Typical High $213.80 | Facility | None | $69.18 | $114.82 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | None | $63.10 | $63.10 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $147.91 Typical High $407.38 | Facility | None | $67.61 | $147.91 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Aultcare Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $77.62 | Professional | None | $57.54 | $57.54 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $134.90 Typical High $208.93 | Facility | None | $117.49 | $134.90 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | None | $63.10 | $63.10 | $67.61 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $72.44 Median $120.23 Typical High $181.97 | Facility | None | $72.44 | $120.23 | $181.97 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | None | $63.10 | $63.10 | $67.61 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $63.10 Typical High $79.43 | Professional | None | $57.54 | $63.10 | $79.43 |
SummaCare Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $77.62 | Professional | None | $63.10 | $66.07 | $77.62 |
United Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $61.66 | Professional | None | $51.29 | $57.54 | $61.66 |
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 $31.62 Median $31.62 Typical High $33.11 | Professional | 52 · Reduced service | $31.62 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $13.18 | Professional | 53 · Discontinued | $12.59 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $10.00 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.61 |
Where Ohio sits
Rates are fairly even across states for this service. 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· 23rd of 51
$63.10
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.