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 $331.13 Median $371.54 Typical High $1,000.00 | Facility | None | $331.13 | $371.54 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $363.08 | Professional | None | $331.13 | $331.13 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $562.34 Typical High $1,000.00 | Facility | None | $346.74 | $562.34 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $467.74 | Professional | None | $331.13 | $331.13 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $426.58 | Professional | None | $316.23 | $316.23 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $707.95 Typical High $1,096.48 | Facility | None | $323.59 | $707.95 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $323.59 Median $707.95 Typical High $954.99 | Facility | None | $323.59 | $707.95 | $954.99 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | None | $331.13 | $331.13 | $338.84 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $537.03 | Professional | None | $323.59 | $338.84 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $407.38 | Professional | None | $331.13 | $346.74 | $407.38 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $363.08 | Professional | None | $295.12 | $331.13 | $363.08 |
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 $165.96 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | 53 · Discontinued | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $54.95 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $36.31 |
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· 40th of 51
$331
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.