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 $32.36 Median $89.13 Typical High $109.65 | Facility | None | $32.36 | $89.13 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $43.65 | Professional | None | $32.36 | $32.36 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $57.54 Typical High $100.00 | Facility | None | $35.48 | $57.54 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | None | $32.36 | $32.36 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
CareSource Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $41.69 | Professional | None | $32.36 | $32.36 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $107.15 | Facility | None | $61.66 | $69.18 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $32.36 Median $69.18 Typical High $93.33 | Facility | None | $32.36 | $69.18 | $93.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $56.23 | Professional | None | $32.36 | $32.36 | $56.23 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $41.69 | Professional | None | $32.36 | $35.48 | $41.69 |
SummaCare Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $39.81 | Professional | None | $32.36 | $33.88 | $39.81 |
United Setting Professional Modifier None Typical Low $29.51 Median $32.36 Typical High $33.88 | Professional | None | $29.51 | $32.36 | $33.88 |
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 $16.22 Median $16.22 Typical High $17.78 | Professional | 52 · Reduced service | $16.22 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $7.08 | Professional | 53 · Discontinued | $6.46 | $6.46 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.37 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.55 |
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· 15th of 51
$32.36
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.