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 $457.09 Median $457.09 Typical High $602.56 | Facility | None | $457.09 | $457.09 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $489.78 | Professional | None | $457.09 | $457.09 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $467.74 Typical High $741.31 | Facility | None | $302.00 | $467.74 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $758.58 | Professional | None | $512.86 | $512.86 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $1,096.48 Typical High $1,445.44 | Facility | None | $302.00 | $1,096.48 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $302.00 Median $1,096.48 Typical High $1,445.44 | Facility | None | $302.00 | $1,096.48 | $1,445.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Molina Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | None | $512.86 | $562.34 | $660.69 |
SummaCare Setting Professional Modifier None Typical Low $70.79 Median $691.83 Typical High $1,288.25 | Professional | None | $70.79 | $691.83 | $1,288.25 |
United Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
United Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $645.65 | Professional | None | $524.81 | $575.44 | $645.65 |
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 $229.09 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $48.98 |
Where Ohio sits
The same service costs 1.6 times more in Alaska than in Idaho. 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
$513
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.