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 $5.01 Median $10.47 Typical High $10.47 | Facility | None | $5.01 | $10.47 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $10.47 Typical High $10.47 | Professional | None | $5.01 | $10.47 | $10.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.07 | Facility | None | $0.02 | $0.03 | $0.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $8.91 Typical High $13.80 | Professional | None | $7.24 | $8.91 | $13.80 |
CareSource Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $25.70 | Facility | None | $19.05 | $19.05 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $15.49 | Professional | None | $8.91 | $8.91 | $15.49 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $25.70 | Facility | None | $19.05 | $19.05 | $25.70 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $15.49 | Professional | None | $8.91 | $8.91 | $15.49 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $50.12 | Professional | None | $39.81 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $22.91 | Professional | None | $15.49 | $15.49 | $22.91 |
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 $2.51 Median $5.25 Typical High $5.25 | Professional | 52 · Reduced service | $2.51 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $2.09 Typical High $2.09 | Professional | 53 · Discontinued | $1.00 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $1.58 Typical High $1.58 | Professional | 55 · Aftercare only | $0.76 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $1.05 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.50 | $1.05 | $1.05 |
Where Ohio sits
The same service costs 2.6 times more in Alaska than in Ohio. 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· 51st of 51
$9.12
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.