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 $33.11 Median $60.26 Typical High $109.65 | Facility | None | $33.11 | $60.26 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $47.86 | Professional | None | $33.11 | $33.11 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.88 Median $54.95 Typical High $100.00 | Facility | None | $33.88 | $54.95 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $46.77 | Professional | None | $33.11 | $33.11 | $46.77 |
Aultcare Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aultcare Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $38.90 | Professional | None | $30.20 | $30.20 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $70.79 Typical High $109.65 | Facility | None | $31.62 | $70.79 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $31.62 Median $66.07 Typical High $93.33 | Facility | None | $31.62 | $66.07 | $93.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $69.18 | Professional | None | $33.11 | $33.11 | $69.18 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $40.74 | Professional | None | $30.90 | $34.67 | $40.74 |
SummaCare Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $40.74 | Professional | None | $33.11 | $34.67 | $40.74 |
United Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $28.84 Median $32.36 Typical High $35.48 | Professional | None | $28.84 | $32.36 | $35.48 |
5 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 $16.60 Median $16.60 Typical High $18.20 | Professional | 52 · Reduced service | $16.60 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $7.24 | Professional | 53 · Discontinued | $6.61 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.37 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.63 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | JZ · No drug discarded | $30.90 | $30.90 | $31.62 |
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· 33rd of 51
$33.11
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.