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 $3.55 Median $3.55 Typical High $19.95 | Facility | None | $3.55 | $3.55 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $15.14 | Professional | None | $3.55 | $3.55 | $15.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.80 Median $6.17 Typical High $10.72 | Facility | None | $3.80 | $6.17 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $6.61 | Professional | None | $3.55 | $3.55 | $6.61 |
CareSource Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
CareSource Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $6.61 Median $7.59 Typical High $11.75 | Facility | None | $6.61 | $7.59 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | None | $3.55 | $3.55 | $4.17 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.61 Median $7.59 Typical High $10.00 | Facility | None | $6.61 | $7.59 | $10.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | None | $3.55 | $3.55 | $4.17 |
Molina Setting Professional Modifier None Typical Low $3.89 Median $4.37 Typical High $5.13 | Professional | None | $3.89 | $4.37 | $5.13 |
SummaCare Setting Professional Modifier None Typical Low $3.55 Median $3.89 Typical High $7.08 | Professional | None | $3.55 | $3.89 | $7.08 |
United Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $5.25 | Professional | None | $3.55 | $3.55 | $5.25 |
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 $1.78 Median $1.78 Typical High $7.59 | Professional | 52 · Reduced service | $1.78 | $1.78 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $3.02 | Professional | 53 · Discontinued | $0.71 | $0.71 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $2.24 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $1.51 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $1.51 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in Illinois. 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
$4.27
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.