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 $295.12 Median $295.12 Typical High $891.25 | Facility | None | $295.12 | $295.12 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | None | $295.12 | $295.12 | $338.84 |
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 $323.59 Median $323.59 Typical High $467.74 | Professional | None | $323.59 | $323.59 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $11.48 Median $114.82 Typical High $114.82 | Professional | None | $11.48 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $691.83 Typical High $933.25 | Facility | None | $323.59 | $691.83 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | None | $323.59 | $323.59 | $371.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $323.59 Median $691.83 Typical High $933.25 | Facility | None | $323.59 | $691.83 | $933.25 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | None | $323.59 | $323.59 | $371.54 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $416.87 | Professional | None | $323.59 | $354.81 | $416.87 |
SummaCare Setting Professional Modifier None Typical Low $70.79 Median $213.80 Typical High $812.83 | Professional | None | $70.79 | $213.80 | $812.83 |
United Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $346.74 | Professional | None | $281.84 | $323.59 | $346.74 |
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 $147.91 Median $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $147.91 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $63.10 | Professional | 53 · Discontinued | $58.88 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $47.86 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $31.62 |
Where Ohio sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 10th of 51
$324
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.