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 $2.95 Median $6.92 Typical High $10.00 | Facility | None | $2.95 | $6.92 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $3.39 Typical High $15.14 | Professional | None | $2.95 | $3.39 | $15.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.89 Median $8.32 Typical High $23.44 | Facility | None | $3.89 | $8.32 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $2.95 Typical High $5.25 | Professional | None | $2.51 | $2.95 | $5.25 |
Aultcare Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
CareSource Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
CareSource Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.01 Median $7.94 Typical High $19.05 | Facility | None | $5.01 | $7.94 | $19.05 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $9.55 | Professional | None | $2.95 | $2.95 | $9.55 |
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 $2.95 Median $3.24 Typical High $5.89 | Professional | None | $2.95 | $3.24 | $5.89 |
United Setting Professional Modifier None Typical Low $3.63 Median $4.17 Typical High $7.76 | Professional | None | $3.63 | $4.17 | $7.76 |
5 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 $1.48 Median $1.48 Typical High $8.51 | Professional | 52 · Reduced service | $1.48 | $1.48 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $3.39 | Professional | 53 · Discontinued | $0.59 | $0.59 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $2.51 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $1.70 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | JZ · No drug discarded | $4.68 | $4.68 | $4.68 |
Where Ohio sits
The same service costs 2.8 times more in Wyoming than in Florida. 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· 21st of 51
$3.72
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.