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 $30.90 Median $85.11 Typical High $123.03 | Facility | None | $30.90 | $85.11 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | None | $30.90 | $30.90 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.11 Median $53.70 Typical High $93.33 | Facility | None | $33.11 | $53.70 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $43.65 | Professional | None | $30.90 | $30.90 | $43.65 |
CareSource Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
CareSource Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $66.07 Typical High $102.33 | Facility | None | $30.90 | $66.07 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | None | $30.90 | $30.90 | $32.36 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $30.90 Median $66.07 Typical High $89.13 | Facility | None | $30.90 | $66.07 | $89.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | None | $30.90 | $30.90 | $32.36 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $39.81 | Professional | None | $30.90 | $33.88 | $39.81 |
SummaCare Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $38.02 | Professional | None | $30.90 | $32.36 | $38.02 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $28.18 Median $32.36 Typical High $34.67 | Professional | None | $28.18 | $32.36 | $34.67 |
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 $15.49 Median $15.49 Typical High $16.98 | Professional | 52 · Reduced service | $15.49 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.76 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $5.13 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.39 |
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· 50th of 51
$30.90
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.