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 $2,884.03 Median $7,585.78 Typical High $9,772.37 | Facility | None | $2,884.03 | $7,585.78 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,311.31 | Professional | None | $2,884.03 | $2,884.03 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $4,897.79 Typical High $8,709.64 | Facility | None | $3,019.95 | $4,897.79 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $4,073.80 | Professional | None | $2,884.03 | $2,884.03 | $4,073.80 |
CareSource Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,630.78 | Professional | None | $2,691.53 | $2,691.53 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $6,165.95 Typical High $9,549.93 | Facility | None | $2,818.38 | $6,165.95 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2,818.38 Median $6,165.95 Typical High $8,317.64 | Facility | None | $2,818.38 | $6,165.95 | $8,317.64 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,162.28 | Professional | None | $2,884.03 | $2,884.03 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $2,818.38 Median $3,090.30 Typical High $3,630.78 | Professional | None | $2,818.38 | $3,090.30 | $3,630.78 |
SummaCare Setting Professional Modifier None Typical Low $2,884.03 Median $3,019.95 Typical High $3,548.13 | Professional | None | $2,884.03 | $3,019.95 | $3,548.13 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
United Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $3,162.28 | Professional | None | $2,570.40 | $2,884.03 | $3,162.28 |
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 $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 53 · Discontinued | $575.44 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $316.23 |
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· 28th of 51
$2,884
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.