How much rates vary
Facilitymedian $339 · 10th to 90th $191 to $617Professionalmedian $191 · 10th to 90th $186 to $257
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 $229.09 Median $416.87 Typical High $645.65 | Facility | None | $229.09 | $416.87 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $281.84 | Professional | None | $190.55 | $190.55 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $302.00 Typical High $575.44 | Facility | None | $204.17 | $302.00 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $269.15 | Professional | None | $190.55 | $190.55 | $269.15 |
Aultcare Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aultcare Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $239.88 | Professional | None | $181.97 | $181.97 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $407.38 Typical High $630.96 | Facility | None | $186.21 | $407.38 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $186.21 Median $398.11 Typical High $549.54 | Facility | None | $186.21 | $398.11 | $549.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $323.59 | Professional | None | $190.55 | $190.55 | $323.59 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $245.47 | Professional | None | $186.21 | $204.17 | $245.47 |
SummaCare Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $234.42 | Professional | None | $190.55 | $199.53 | $234.42 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $208.93 | Professional | None | $173.78 | $194.98 | $208.93 |
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 $95.50 Median $95.50 Typical High $104.71 | Professional | 52 · Reduced service | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $38.02 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $20.89 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | JW · Drug discarded | $186.21 | $186.21 | $186.21 |
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· 42nd of 51
$191
AK $234MA $191
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.