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 $17.78 Median $38.02 Typical High $91.20 | Facility | None | $17.78 | $38.02 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $67.61 | Professional | None | $16.22 | $17.78 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $18.20 Typical High $24.55 | Professional | None | $13.18 | $18.20 | $24.55 |
Aultcare Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aultcare Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $26.30 | Professional | None | $18.62 | $18.62 | $26.30 |
CareSource Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
CareSource Setting Professional Modifier None Typical Low $26.30 Median $27.54 Typical High $35.48 | Professional | None | $26.30 | $27.54 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $43.65 | Professional | None | $22.39 | $23.44 | $43.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $51.29 Median $85.11 Typical High $134.90 | Facility | None | $51.29 | $85.11 | $134.90 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $16.98 Median $17.38 Typical High $34.67 | Professional | None | $16.98 | $17.38 | $34.67 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $19.50 | Professional | None | $16.60 | $16.60 | $19.50 |
SummaCare Setting Professional Modifier None Typical Low $22.39 Median $28.18 Typical High $34.67 | Professional | None | $22.39 | $28.18 | $34.67 |
United Setting Facility Modifier None Typical Low $22.39 Median $25.12 Typical High $30.20 | Facility | None | $22.39 | $25.12 | $30.20 |
United Setting Professional Modifier None Typical Low $19.05 Median $23.44 Typical High $30.20 | Professional | None | $19.05 | $23.44 | $30.20 |
3 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $15.85 Median $15.85 Typical High $18.20 | Professional | 59 · Distinct service | $15.85 | $15.85 | $18.20 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | GO · Occupational therapy plan | $21.38 | $21.38 | $21.38 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $15.85 Median $21.38 Typical High $25.70 | Professional | GP · Physical therapy plan | $15.85 | $21.38 | $25.70 |
Where Ohio sits
The same service costs 3.0 times more in Minnesota than in Ohio. 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· 51st of 51
$17.78
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.