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 $131.83 Median $147.91 Typical High $1,258.93 | Facility | None | $131.83 | $147.91 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $954.99 | Professional | None | $131.83 | $131.83 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $208.93 Typical High $398.11 | Facility | None | $128.82 | $208.93 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $281.84 | Professional | None | $131.83 | $131.83 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
CareSource Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $281.84 Typical High $426.58 | Facility | None | $120.23 | $281.84 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $389.05 | Professional | None | $131.83 | $131.83 | $389.05 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $120.23 Median $281.84 Typical High $380.19 | Facility | None | $120.23 | $281.84 | $380.19 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $389.05 | Professional | None | $131.83 | $131.83 | $389.05 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $186.21 | Professional | None | $131.83 | $165.96 | $186.21 |
SummaCare Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $263.03 | Professional | None | $138.04 | $144.54 | $263.03 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $257.04 | Professional | None | $120.23 | $131.83 | $257.04 |
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 $66.07 Median $66.07 Typical High $478.63 | Professional | 52 · Reduced service | $66.07 | $66.07 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $190.55 | Professional | 53 · Discontinued | $26.30 | $26.30 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $144.54 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $95.50 |
Where Ohio sits
The same service costs 8.7 times more in Texas than in Kansas. 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· 8th of 51
$148
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.