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 $1,071.52 Typical High $1,318.26 | Facility | None | $389.05 | $1,071.52 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $977.24 | Professional | None | $389.05 | $389.05 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $676.08 Typical High $1,174.90 | Facility | None | $416.87 | $676.08 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $724.44 | Professional | None | $389.05 | $389.05 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $1,288.25 | Facility | None | $389.05 | $831.76 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | None | $389.05 | $389.05 | $398.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $1,122.02 | Facility | None | $389.05 | $831.76 | $1,122.02 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | None | $389.05 | $389.05 | $398.11 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $549.54 | Professional | None | $389.05 | $426.58 | $549.54 |
SummaCare Setting Professional Modifier None Typical Low $100.00 Median $407.38 Typical High $741.31 | Professional | None | $100.00 | $407.38 | $741.31 |
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 $154.88 Median $389.05 Typical High $524.81 | Professional | None | $154.88 | $389.05 | $524.81 |
5 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 $478.63 | Professional | 52 · Reduced service | $194.98 | $194.98 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $194.98 | Professional | 53 · Discontinued | $77.62 | $77.62 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $144.54 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $97.72 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $97.72 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $331.13 Median $331.13 Typical High $389.05 | Professional | JZ · No drug discarded | $331.13 | $331.13 | $389.05 |
Where Ohio sits
The same service costs 1.7 times more in Alaska 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· 21st of 51
$389
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.