How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $13.18 Median $13.18 Typical High $93.33 | Facility | None | $13.18 | $13.18 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $70.79 | Professional | None | $13.18 | $13.18 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $1.00 Typical High $1.58 | Professional | None | $0.79 | $1.00 | $1.58 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $50.12 | Professional | None | $39.81 | $50.12 | $50.12 |
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 $6.61 Median $6.61 Typical High $35.48 | Professional | 52 · Reduced service | $6.61 | $6.61 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $14.13 | Professional | 53 · Discontinued | $2.63 | $2.63 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $10.72 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $7.08 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $7.08 |
Where Ohio sits
The same service costs 1412.5 times more in Wyoming than in Missouri. 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
$1.07
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.