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 $281.84 Median $537.03 Typical High $933.25 | Facility | None | $281.84 | $537.03 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | None | $281.84 | $281.84 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $436.52 Typical High $831.76 | Facility | None | $288.40 | $436.52 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Aultcare Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $346.74 | Professional | None | $257.04 | $257.04 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $602.56 Typical High $912.01 | Facility | None | $269.15 | $602.56 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $269.15 Median $602.56 Typical High $794.33 | Facility | None | $269.15 | $602.56 | $794.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | None | $257.04 | $281.84 | $281.84 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $346.74 | Professional | None | $269.15 | $295.12 | $346.74 |
SummaCare Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $346.74 | Professional | None | $281.84 | $295.12 | $346.74 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $302.00 | Professional | None | $245.47 | $275.42 | $302.00 |
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 $138.04 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $138.04 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $61.66 | Professional | 53 · Discontinued | $56.23 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $30.90 |
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· 27th of 51
$282
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.