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 $537.03 Median $1,479.11 Typical High $2,041.74 | Facility | None | $537.03 | $1,479.11 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,621.81 | Professional | None | $537.03 | $537.03 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $912.01 Typical High $1,621.81 | Facility | None | $575.44 | $912.01 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $1,122.02 | Professional | None | $524.81 | $537.03 | $1,122.02 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
CareSource Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,778.28 | Facility | None | $1,000.00 | $1,148.15 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,380.38 | Professional | None | $537.03 | $537.03 | $1,380.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,548.82 | Facility | None | $1,000.00 | $1,148.15 | $1,548.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,380.38 | Professional | None | $537.03 | $537.03 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $758.58 | Professional | None | $575.44 | $660.69 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $1,071.52 | Professional | None | $537.03 | $588.84 | $1,071.52 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $776.25 | Professional | None | $524.81 | $524.81 | $776.25 |
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 $269.15 Median $269.15 Typical High $812.83 | Professional | 52 · Reduced service | $269.15 | $269.15 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $323.59 | Professional | 53 · Discontinued | $107.15 | $107.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $239.88 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $162.18 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $162.18 |
Where Ohio sits
The same service costs 5.0 times more in Wyoming 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· 5th of 51
$676
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.