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 $41.69 | Facility | None | $3.02 | $10.00 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $5.50 Typical High $33.88 | Professional | None | $3.02 | $5.50 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $10.00 Typical High $18.20 | Professional | None | $7.76 | $10.00 | $18.20 |
CareSource Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
CareSource Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $11.75 Typical High $28.84 | Professional | None | $10.96 | $11.75 | $28.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $13.49 Median $46.77 Typical High $120.23 | Facility | None | $13.49 | $46.77 | $120.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $10.96 Median $11.75 Typical High $28.84 | Professional | None | $10.96 | $11.75 | $28.84 |
SummaCare Setting Professional Modifier None Typical Low $12.30 Median $15.14 Typical High $17.78 | Professional | None | $12.30 | $15.14 | $17.78 |
United Setting Professional Modifier None Typical Low $7.41 Median $11.48 Typical High $15.85 | Professional | None | $7.41 | $11.48 | $15.85 |
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 $14.45 | Professional | 52 · Reduced service | $1.51 | $1.51 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $5.75 | Professional | 53 · Discontinued | $0.60 | $0.60 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $4.37 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $2.88 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $2.88 |
Where Ohio sits
The same service costs 6.6 times more in Alabama 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· 44th of 51
$10.72
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.