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 $54.95 Median $151.36 Typical High $281.84 | Facility | None | $54.95 | $151.36 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $63.10 | Professional | None | $54.95 | $54.95 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $165.96 | Facility | None | $60.26 | $89.13 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $79.43 | Professional | None | $54.95 | $54.95 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $93.33 | Professional | None | $67.61 | $69.18 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $117.49 Typical High $173.78 | Facility | None | $54.95 | $117.49 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $54.95 Median $117.49 Typical High $158.49 | Facility | None | $54.95 | $117.49 | $158.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | None | $54.95 | $54.95 | $74.13 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $70.79 | Professional | None | $54.95 | $61.66 | $70.79 |
SummaCare Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $67.61 | Professional | None | $54.95 | $57.54 | $67.61 |
United Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $63.10 | Professional | None | $51.29 | $58.88 | $63.10 |
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 $27.54 Median $27.54 Typical High $30.20 | Professional | 52 · Reduced service | $27.54 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $12.02 | Professional | 53 · Discontinued | $10.96 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $9.12 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $6.03 |
Where Ohio sits
Rates are fairly even across states for this service. 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· 38th of 51
$54.95
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.