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 $29.51 Median $29.51 Typical High $151.36 | Facility | None | $29.51 | $29.51 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $33.11 | Professional | None | $29.51 | $29.51 | $33.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.07 | Facility | None | $0.02 | $0.03 | $0.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | None | $32.36 | $32.36 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
CareSource Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $14.79 | Professional | None | $11.48 | $11.48 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $67.61 Typical High $89.13 | Facility | None | $31.62 | $67.61 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $31.62 Median $67.61 Typical High $89.13 | Facility | None | $31.62 | $67.61 | $89.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $42.66 | Professional | None | $32.36 | $35.48 | $42.66 |
SummaCare Setting Professional Modifier None Typical Low $22.39 Median $70.79 Typical High $87.10 | Professional | None | $22.39 | $70.79 | $87.10 |
United Setting Professional Modifier None Typical Low $28.18 Median $31.62 Typical High $34.67 | Professional | None | $28.18 | $31.62 | $34.67 |
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 $14.79 Median $14.79 Typical High $16.60 | Professional | 52 · Reduced service | $14.79 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $6.61 | Professional | 53 · Discontinued | $5.89 | $5.89 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.90 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.31 |
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· 15th of 51
$31.62
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.