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 $3.02 Median $10.00 Typical High $53.70 | Facility | None | $3.02 | $10.00 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $5.50 Typical High $43.65 | Professional | None | $3.02 | $5.50 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.75 Median $15.49 Typical High $25.12 | Professional | None | $11.75 | $15.49 | $25.12 |
CareSource Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
CareSource Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $16.22 Typical High $39.81 | Professional | None | $12.02 | $16.22 | $39.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $199.53 | Facility | None | $109.65 | $109.65 | $199.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $12.02 Median $16.22 Typical High $39.81 | Professional | None | $12.02 | $16.22 | $39.81 |
SummaCare Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $32.36 | Professional | None | $17.38 | $18.20 | $32.36 |
United Setting Facility Modifier None Typical Low $147.91 Median $173.78 Typical High $245.47 | Facility | None | $147.91 | $173.78 | $245.47 |
United Setting Professional Modifier None Typical Low $7.76 Median $14.45 Typical High $25.70 | Professional | None | $7.76 | $14.45 | $25.70 |
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 $1.51 Median $1.51 Typical High $19.50 | Professional | 52 · Reduced service | $1.51 | $1.51 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $7.76 | Professional | 53 · Discontinued | $0.60 | $0.60 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $5.89 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $3.89 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $3.89 |
Where Ohio sits
The same service costs 5.2 times more in Texas than in Kentucky. 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· 43rd of 51
$15.49
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.