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 $691.83 Median $758.58 Typical High $1,905.46 | Facility | None | $691.83 | $758.58 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $758.58 | Professional | None | $691.83 | $691.83 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $2,089.30 | Facility | None | $741.31 | $1,202.26 | $2,089.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $977.24 | Professional | None | $691.83 | $691.83 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
CareSource Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | None | $691.83 | $691.83 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,479.11 Typical High $2,238.72 | Facility | None | $691.83 | $1,479.11 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $691.83 Median $1,479.11 Typical High $1,949.84 | Facility | None | $691.83 | $1,479.11 | $1,949.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | None | $691.83 | $691.83 | $707.95 |
Molina Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $851.14 | Professional | None | $691.83 | $724.44 | $851.14 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
United Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $776.25 | Professional | None | $630.96 | $707.95 | $776.25 |
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 $338.84 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $75.86 |
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
$692
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.