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 $58.88 Median $107.15 Typical High $316.23 | Facility | None | $58.88 | $107.15 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | None | $58.88 | $58.88 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $95.50 Typical High $177.83 | Facility | None | $63.10 | $95.50 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $85.11 | Professional | None | $58.88 | $58.88 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $125.89 Typical High $190.55 | Facility | None | $61.66 | $125.89 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | None | $58.88 | $58.88 | $79.43 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $61.66 Median $125.89 Typical High $165.96 | Facility | None | $61.66 | $125.89 | $165.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | None | $58.88 | $58.88 | $79.43 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $75.86 | Professional | None | $58.88 | $66.07 | $75.86 |
SummaCare Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $72.44 | Professional | None | $58.88 | $61.66 | $72.44 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $67.61 | Professional | None | $54.95 | $63.10 | $67.61 |
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 $28.84 Median $28.84 Typical High $32.36 | Professional | 52 · Reduced service | $28.84 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $12.88 | Professional | 53 · Discontinued | $11.75 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $9.77 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.46 |
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· 41st of 51
$58.88
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.