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 $19.95 Median $33.88 Typical High $57.54 | Facility | None | $19.95 | $33.88 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $33.88 | Professional | None | $17.38 | $17.38 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.20 Median $26.92 Typical High $51.29 | Facility | None | $18.20 | $26.92 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $24.55 | Professional | None | $17.38 | $17.38 | $24.55 |
Aultcare Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aultcare Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
CareSource Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
CareSource Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $21.88 | Professional | None | $16.98 | $16.98 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $37.15 Typical High $56.23 | Facility | None | $16.98 | $37.15 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $16.98 Median $32.36 Typical High $48.98 | Facility | None | $16.98 | $32.36 | $48.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $19.50 | Professional | None | $17.38 | $17.38 | $19.50 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $21.88 | Professional | None | $16.98 | $18.62 | $21.88 |
SummaCare Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $28.18 | Professional | None | $17.38 | $18.20 | $28.18 |
United Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $15.49 Median $17.38 Typical High $19.05 | Professional | None | $15.49 | $17.38 | $19.05 |
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 $8.51 Median $8.51 Typical High $9.55 | Professional | 52 · Reduced service | $8.51 | $8.51 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.80 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.91 |
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· 37th of 51
$17.38
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.