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 $63.10 Median $100.00 Typical High $144.54 | Facility | None | $63.10 | $100.00 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $93.33 | Professional | None | $36.31 | $36.31 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $57.54 Typical High $109.65 | Facility | None | $38.90 | $57.54 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $52.48 | Professional | None | $36.31 | $36.31 | $52.48 |
Aultcare Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | None | $36.31 | $36.31 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $77.62 Typical High $120.23 | Facility | None | $37.15 | $77.62 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $45.71 | Professional | None | $36.31 | $36.31 | $45.71 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $37.15 Median $77.62 Typical High $104.71 | Facility | None | $37.15 | $77.62 | $104.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $47.86 | Professional | None | $36.31 | $36.31 | $47.86 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $46.77 | Professional | None | $36.31 | $39.81 | $46.77 |
SummaCare Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $44.67 | Professional | None | $36.31 | $38.02 | $44.67 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $33.11 Median $38.02 Typical High $40.74 | Professional | None | $33.11 | $38.02 | $40.74 |
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 $18.20 Median $18.20 Typical High $19.95 | Professional | 52 · Reduced service | $18.20 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.94 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.03 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.98 |
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· 32nd of 51
$36.31
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.