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 $1.38 Median $1.38 Typical High $7.94 | Facility | None | $1.38 | $1.38 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $6.03 | Professional | None | $1.38 | $1.38 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.38 Median $2.24 Typical High $4.17 | Facility | None | $1.38 | $2.24 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $2.29 | Professional | None | $1.38 | $1.38 | $2.29 |
CareSource Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Facility | None | $1.29 | $1.29 | $1.29 |
CareSource Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $3.02 Typical High $4.57 | Facility | None | $2.57 | $3.02 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.51 | Professional | None | $1.41 | $1.41 | $1.51 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.45 Median $3.02 Typical High $4.07 | Facility | None | $2.45 | $3.02 | $4.07 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.51 | Professional | None | $1.41 | $1.41 | $1.51 |
Molina Setting Professional Modifier None Typical Low $1.41 Median $1.74 Typical High $1.95 | Professional | None | $1.41 | $1.74 | $1.95 |
SummaCare Setting Professional Modifier None Typical Low $1.38 Median $1.51 Typical High $2.75 | Professional | None | $1.38 | $1.51 | $2.75 |
United Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Facility | None | $1.38 | $1.38 | $1.38 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.91 | Professional | None | $1.29 | $1.29 | $1.91 |
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 $0.69 Median $0.69 Typical High $3.02 | Professional | 52 · Reduced service | $0.69 | $0.69 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $1.20 | Professional | 53 · Discontinued | $0.28 | $0.28 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.89 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.60 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in Iowa. 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· 6th of 51
$1.58
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.