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 $72.44 Median $109.65 Typical High $204.17 | Facility | None | $72.44 | $109.65 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | None | $60.26 | $60.26 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $97.72 Typical High $181.97 | Facility | None | $60.26 | $97.72 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $85.11 | Professional | None | $60.26 | $60.26 | $85.11 |
Aultcare Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | None | $56.23 | $56.23 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $128.82 Typical High $199.53 | Facility | None | $56.23 | $128.82 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | None | $60.26 | $60.26 | $64.57 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $56.23 Median $128.82 Typical High $173.78 | Facility | None | $56.23 | $128.82 | $173.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $95.50 | Professional | None | $60.26 | $60.26 | $95.50 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $75.86 | Professional | None | $56.23 | $61.66 | $75.86 |
SummaCare Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $74.13 | Professional | None | $60.26 | $63.10 | $74.13 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $63.10 | Professional | None | $51.29 | $58.88 | $63.10 |
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 $30.20 Median $30.20 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | 53 · Discontinued | $12.02 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.61 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | JW · Drug discarded | $79.43 | $79.43 | $79.43 |
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· 48th of 51
$60.26
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.