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 $6.76 Median $18.62 Typical High $199.53 | Facility | None | $6.76 | $18.62 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $10.23 | Professional | None | $6.76 | $6.76 | $10.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $33.11 Typical High $52.48 | Facility | None | $20.89 | $33.11 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $19.50 | Professional | None | $12.88 | $12.88 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $28.18 | Facility | None | $20.89 | $20.89 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $28.18 | Facility | None | $20.89 | $20.89 | $28.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $4.57 Median $6.76 Typical High $7.76 | Professional | None | $4.57 | $6.76 | $7.76 |
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 $3.39 Median $3.39 Typical High $5.13 | Professional | 52 · Reduced service | $3.39 | $3.39 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $1.35 Typical High $2.09 | Professional | 53 · Discontinued | $1.35 | $1.35 | $2.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.00 Typical High $1.55 | Professional | 55 · Aftercare only | $1.00 | $1.00 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.68 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.68 | $0.68 | $1.05 |
Where Ohio sits
The same service costs 46.8 times more in New York than in Arkansas. 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· 20th of 51
$9.77
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.