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 $213.80 Median $213.80 Typical High $588.84 | Facility | None | $213.80 | $213.80 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $575.44 | Professional | None | $213.80 | $213.80 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $645.65 | Facility | None | $229.09 | $371.54 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $407.38 | Professional | None | $213.80 | $213.80 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $457.09 Typical High $707.95 | Facility | None | $407.38 | $457.09 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | None | $213.80 | $213.80 | $245.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $407.38 Median $457.09 Typical High $616.60 | Facility | None | $407.38 | $457.09 | $616.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | None | $213.80 | $213.80 | $245.47 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $309.03 | Professional | None | $234.42 | $269.15 | $309.03 |
SummaCare Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $426.58 | Professional | None | $213.80 | $234.42 | $426.58 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $316.23 | Professional | None | $213.80 | $213.80 | $316.23 |
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 $107.15 Median $107.15 Typical High $288.40 | Professional | 52 · Reduced service | $107.15 | $107.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $114.82 | Professional | 53 · Discontinued | $42.66 | $42.66 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $85.11 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $57.54 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $57.54 |
Where Ohio sits
The same service costs 7.6 times more in Alabama than in New Mexico. 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· 4th of 51
$257
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.