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 $38.02 Median $69.18 Typical High $125.89 | Facility | None | $38.02 | $69.18 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $67.61 | Professional | None | $38.02 | $38.02 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $64.57 Typical High $114.82 | Facility | None | $39.81 | $64.57 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $53.70 | Professional | None | $38.02 | $38.02 | $53.70 |
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 $46.77 | Professional | None | $36.31 | $36.31 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $81.28 Typical High $123.03 | Facility | None | $37.15 | $81.28 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $37.15 Median $81.28 Typical High $109.65 | Facility | None | $37.15 | $81.28 | $109.65 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $43.65 | Professional | None | $38.02 | $38.02 | $43.65 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $60.26 | Professional | None | $37.15 | $38.90 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $46.77 | Professional | None | $38.02 | $39.81 | $46.77 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $33.88 Median $38.02 Typical High $41.69 | Professional | None | $33.88 | $38.02 | $41.69 |
5 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 $18.62 Median $18.62 Typical High $20.89 | Professional | 52 · Reduced service | $18.62 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $8.32 | Professional | 53 · Discontinued | $7.59 | $7.59 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $6.17 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $4.17 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | JW · Drug discarded | $51.29 | $51.29 | $51.29 |
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· 43rd of 51
$38.02
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.