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 $173.78 Median $416.87 Typical High $537.03 | Facility | None | $173.78 | $416.87 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $251.19 | Professional | None | $151.36 | $151.36 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $199.53 | Professional | None | $128.82 | $151.36 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | None | $151.36 | $151.36 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $275.42 Typical High $416.87 | Facility | None | $239.88 | $275.42 | $416.87 |
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 $239.88 Median $275.42 Typical High $416.87 | Facility | None | $239.88 | $275.42 | $416.87 |
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 $165.96 | Professional | None | $117.49 | $125.89 | $165.96 |
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 $75.86 Median $75.86 Typical High $97.72 | Professional | 52 · Reduced service | $75.86 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $38.90 | Professional | 53 · Discontinued | $30.20 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $29.51 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $19.50 |
Where Ohio sits
The same service costs 2.9 times more in Wyoming 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· 16th of 51
$151
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.