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 $1.29 Median $3.24 Typical High $6.31 | Facility | None | $1.29 | $3.24 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.45 | Professional | None | $1.29 | $1.29 | $1.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.41 Median $3.02 Typical High $8.51 | Facility | None | $1.41 | $3.02 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.12 Median $1.29 Typical High $2.29 | Professional | None | $1.12 | $1.29 | $2.29 |
Aultcare Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
CareSource Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Facility | None | $1.23 | $1.23 | $1.23 |
CareSource Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
Cigna Setting Facility Modifier None Typical Low $2.45 Median $2.82 Typical High $4.27 | Facility | None | $2.45 | $2.82 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $3.02 | Professional | None | $1.29 | $1.29 | $3.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.24 Median $2.82 Typical High $5.62 | Facility | None | $2.24 | $2.82 | $5.62 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $4.37 | Professional | None | $1.29 | $1.29 | $4.37 |
Molina Setting Professional Modifier None Typical Low $1.10 Median $1.58 Typical High $1.82 | Professional | None | $1.10 | $1.58 | $1.82 |
SummaCare Setting Professional Modifier None Typical Low $1.29 Median $2.45 Typical High $11.22 | Professional | None | $1.29 | $2.45 | $11.22 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.86 | Professional | None | $1.26 | $1.26 | $1.86 |
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 $0.65 Median $0.65 Typical High $0.65 | Professional | 52 · Reduced service | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $7.41 | Professional | 53 · Discontinued | $0.26 | $0.26 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $5.50 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $3.72 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $3.72 |
Where Ohio sits
The same service costs 2.5 times more in Texas than in Nebraska. 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· 18th of 51
$1.38
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.