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 $56.23 Median $63.10 Typical High $218.78 | Facility | None | $56.23 | $63.10 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $66.07 | Professional | None | $56.23 | $56.23 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $169.82 | Facility | None | $57.54 | $93.33 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $79.43 | Professional | None | $56.23 | $56.23 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $70.79 | Professional | None | $52.48 | $52.48 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $120.23 Typical High $186.21 | Facility | None | $53.70 | $120.23 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Professional | None | $56.23 | $56.23 | $60.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $53.70 Median $120.23 Typical High $162.18 | Facility | None | $53.70 | $120.23 | $162.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Professional | None | $56.23 | $56.23 | $60.26 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $70.79 | Professional | None | $53.70 | $58.88 | $70.79 |
SummaCare Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $69.18 | Professional | None | $56.23 | $58.88 | $69.18 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $60.26 | Professional | None | $48.98 | $54.95 | $60.26 |
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 $28.18 Median $28.18 Typical High $30.90 | Professional | 52 · Reduced service | $28.18 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $12.30 | Professional | 53 · Discontinued | $11.22 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $9.33 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.17 |
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· 28th of 51
$56.23
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.