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 $389.05 Median $1,096.48 Typical High $2,238.72 | Facility | None | $389.05 | $1,096.48 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $2,238.72 | Professional | None | $389.05 | $389.05 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $676.08 Typical High $1,202.26 | Facility | None | $416.87 | $676.08 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $741.31 | Professional | None | $389.05 | $389.05 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $851.14 Typical High $1,288.25 | Facility | None | $741.31 | $851.14 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $851.14 Typical High $1,122.02 | Facility | None | $549.54 | $851.14 | $1,122.02 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
Molina Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $562.34 | Professional | None | $426.58 | $489.78 | $562.34 |
SummaCare Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $776.25 | Professional | None | $389.05 | $436.52 | $776.25 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $831.76 | Professional | None | $380.19 | $426.58 | $831.76 |
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 $194.98 Median $194.98 Typical High $1,122.02 | Professional | 52 · Reduced service | $194.98 | $194.98 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $446.68 | Professional | 53 · Discontinued | $79.43 | $79.43 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $331.13 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $223.87 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $223.87 |
Where Ohio sits
The same service costs 1.9 times more in Texas than in Illinois. 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
$479
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.