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 $2.88 Median $2.88 Typical High $3.24 | Facility | None | $2.88 | $2.88 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.89 Median $8.13 Typical High $23.44 | Facility | None | $3.89 | $8.13 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $5.62 | Professional | None | $2.88 | $2.88 | $5.62 |
CareSource Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
CareSource Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $6.17 Typical High $9.55 | Facility | None | $5.50 | $6.17 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $11.75 | Professional | None | $2.88 | $2.88 | $11.75 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.17 Median $6.76 Typical High $8.32 | Facility | None | $6.17 | $6.76 | $8.32 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $16.98 | Professional | None | $2.88 | $2.88 | $16.98 |
Molina Setting Professional Modifier None Typical Low $3.63 Median $4.47 Typical High $5.37 | Professional | None | $3.63 | $4.47 | $5.37 |
SummaCare Setting Professional Modifier None Typical Low $2.88 Median $3.16 Typical High $5.75 | Professional | None | $2.88 | $3.16 | $5.75 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $5.37 | Professional | None | $3.55 | $3.55 | $5.37 |
2 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 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $13.80 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $9.12 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $9.12 |
Where Ohio sits
The same service costs 4.8 times more in Oklahoma than in Delaware. 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· 39th of 51
$3.31
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.