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 $1,905.46 Median $1,949.84 Typical High $2,454.71 | Facility | None | $1,905.46 | $1,949.84 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,949.84 | $1,949.84 | $2,041.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,949.84 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,949.84 | $1,949.84 | $2,630.27 |
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 $363.08 | Facility | None | $239.88 | $275.42 | $363.08 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $281.84 | Professional | None | $125.89 | $125.89 | $281.84 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $102.33 | Professional | None | $50.12 | $87.10 | $102.33 |
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 $977.24 Median $977.24 Typical High $1,023.29 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | 53 · Discontinued | $389.05 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $309.03 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $204.17 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $204.17 |
Where Ohio sits
The same service costs 19.5 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· 7th of 51
$1,950
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.