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 $4.17 Median $4.17 Typical High $22.91 | Facility | None | $4.17 | $4.17 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $18.20 | Professional | None | $4.17 | $4.17 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.40 Median $4.17 Typical High $9.33 | Facility | None | $2.40 | $4.17 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $3.24 Typical High $6.03 | Professional | None | $2.63 | $3.24 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $12.88 | Facility | None | $9.55 | $9.55 | $12.88 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.25 | Professional | None | $4.47 | $4.47 | $5.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $12.88 | Facility | None | $9.55 | $9.55 | $12.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.25 | Professional | None | $4.47 | $4.47 | $5.25 |
Molina Setting Professional Modifier None Typical Low $2.82 Median $3.63 Typical High $4.27 | Professional | None | $2.82 | $3.63 | $4.27 |
SummaCare Setting Professional Modifier None Typical Low $4.57 Median $5.01 Typical High $9.12 | Professional | None | $4.57 | $5.01 | $9.12 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
United Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $6.46 | Professional | None | $4.37 | $4.37 | $6.46 |
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 $2.09 Median $2.09 Typical High $8.91 | Professional | 52 · Reduced service | $2.09 | $2.09 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $3.63 | Professional | 53 · Discontinued | $0.83 | $0.83 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $2.69 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $1.82 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $1.82 |
Where Ohio sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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· 49th of 51
$4.17
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.