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 $138.04 Median $380.19 Typical High $467.74 | Facility | None | $138.04 | $380.19 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $173.78 | Professional | None | $138.04 | $138.04 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $190.55 | Professional | None | $117.49 | $138.04 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None | $138.04 | $138.04 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $389.05 | Facility | None | $125.89 | $194.98 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $218.78 | Professional | None | $125.89 | $125.89 | $218.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $363.08 | Facility | None | $125.89 | $177.83 | $363.08 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $218.78 | Professional | None | $125.89 | $125.89 | $218.78 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $131.83 | Professional | None | $79.43 | $97.72 | $131.83 |
SummaCare Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $158.49 | Facility | None | $134.90 | $141.25 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $151.36 | Professional | None | $109.65 | $123.03 | $151.36 |
United Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $169.82 | Professional | None | $117.49 | $125.89 | $169.82 |
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 $69.18 Median $69.18 Typical High $83.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $27.54 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $25.12 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $16.60 |
Where Ohio sits
The same service costs 2.2 times more in Alaska than in North Carolina. 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· 29th of 51
$138
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.