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 $691.83 Median $1,548.82 Typical High $2,570.40 | Facility | None | $691.83 | $1,548.82 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $2,630.27 | Professional | None | $562.34 | $741.31 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,148.15 Typical High $1,905.46 | Facility | None | $660.69 | $1,148.15 | $1,905.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,202.26 | Professional | None | $562.34 | $562.34 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,862.09 | Facility | None | $1,071.52 | $1,202.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,819.70 | Professional | None | $562.34 | $562.34 | $1,819.70 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,621.81 | Facility | None | $1,202.26 | $1,230.27 | $1,621.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,819.70 | Professional | None | $562.34 | $562.34 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $912.01 | Professional | None | $616.60 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,122.02 | Professional | None | $562.34 | $616.60 | $1,122.02 |
United Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
United Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $977.24 | Professional | None | $660.69 | $660.69 | $977.24 |
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 $281.84 Median $281.84 Typical High $1,380.38 | Professional | 52 · Reduced service | $281.84 | $281.84 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $549.54 | Professional | 53 · Discontinued | $112.20 | $112.20 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $407.38 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $275.42 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $275.42 |
Where Ohio sits
The same service costs 2.7 times more in Wyoming than in Georgia. 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· 6th of 51
$813
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.