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 $602.56 Median $851.14 Typical High $1,380.38 | Facility | None | $602.56 | $851.14 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | None | $407.38 | $407.38 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $676.08 Typical High $1,258.93 | Facility | None | $426.58 | $676.08 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $575.44 | Professional | None | $407.38 | $407.38 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $891.25 Typical High $1,174.90 | Facility | None | $389.05 | $891.25 | $1,174.90 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | None | $407.38 | $407.38 | $478.63 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $512.86 | Professional | None | $389.05 | $426.58 | $512.86 |
SummaCare Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $501.19 | Professional | None | $407.38 | $426.58 | $501.19 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $436.52 | Professional | None | $363.08 | $407.38 | $436.52 |
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 $204.17 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $81.28 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $44.67 |
Where Ohio sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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· 44th of 51
$407
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.