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 $707.95 Median $707.95 Typical High $3,548.13 | Facility | None | $707.95 | $707.95 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,230.27 | Professional | None | $707.95 | $707.95 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $954.99 | Professional | None | $602.56 | $707.95 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
CareSource Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | None | $707.95 | $707.95 | $954.99 |
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 $30.20 Median $93.33 Typical High $131.83 | Professional | None | $30.20 | $93.33 | $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 $354.81 Median $354.81 Typical High $616.60 | Professional | 52 · Reduced service | $354.81 | $354.81 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $245.47 | Professional | 53 · Discontinued | $141.25 | $141.25 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $186.21 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $123.03 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $123.03 |
Where Ohio sits
The same service costs 13.2 times more in Hawaii 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· 23rd of 51
$631
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.