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 $1,258.93 Median $1,412.54 Typical High $3,801.89 | Facility | None | $1,258.93 | $1,412.54 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,258.93 | $1,258.93 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,348.96 | $2,238.72 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,258.93 | $1,778.28 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,318.26 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,691.53 Typical High $4,073.80 | Facility | None | $1,318.26 | $2,691.53 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,318.26 Median $2,691.53 Typical High $3,548.13 | Facility | None | $1,318.26 | $2,691.53 | $3,548.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,412.54 | $1,621.81 |
SummaCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,318.26 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,412.54 | Professional | None | $1,174.90 | $1,348.96 | $1,412.54 |
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 $616.60 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $144.54 |
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· 34th of 51
$1,259
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.