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 $144.54 Median $263.03 Typical High $478.63 | Facility | None | $144.54 | $263.03 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $223.87 | Professional | None | $144.54 | $144.54 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $436.52 | Facility | None | $147.91 | $239.88 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $204.17 | Professional | None | $144.54 | $144.54 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None | $138.04 | $138.04 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $309.03 Typical High $478.63 | Facility | None | $138.04 | $309.03 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $138.04 Median $309.03 Typical High $416.87 | Facility | None | $138.04 | $309.03 | $416.87 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | None | $144.54 | $144.54 | $169.82 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $177.83 | Professional | None | $138.04 | $151.36 | $177.83 |
SummaCare Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $177.83 | Professional | None | $144.54 | $151.36 | $177.83 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $154.88 | Professional | None | $125.89 | $141.25 | $154.88 |
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 $72.44 Median $72.44 Typical High $79.43 | Professional | 52 · Reduced service | $72.44 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | 53 · Discontinued | $28.84 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $23.44 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $15.85 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $15.85 |
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· 47th of 51
$145
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.