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 $4.37 Median $10.72 Typical High $14.79 | Facility | None | $4.37 | $10.72 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $10.96 | Professional | None | $4.37 | $4.37 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.57 Median $7.41 Typical High $13.49 | Facility | None | $4.57 | $7.41 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.72 Median $4.37 Typical High $6.92 | Professional | None | $3.72 | $4.37 | $6.92 |
CareSource Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
CareSource Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $9.33 Typical High $14.45 | Facility | None | $8.32 | $9.33 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $7.08 | Professional | None | $4.37 | $4.37 | $7.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7.94 Median $9.33 Typical High $12.59 | Facility | None | $7.94 | $9.33 | $12.59 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $7.08 | Professional | None | $4.37 | $4.37 | $7.08 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $5.50 Typical High $6.17 | Professional | None | $4.68 | $5.50 | $6.17 |
SummaCare Setting Professional Modifier None Typical Low $4.37 Median $4.79 Typical High $8.71 | Professional | None | $4.37 | $4.79 | $8.71 |
United Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
United Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $6.31 | Professional | None | $4.27 | $4.27 | $6.31 |
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 $2.19 Median $2.19 Typical High $5.50 | Professional | 52 · Reduced service | $2.19 | $2.19 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.87 Typical High $2.19 | Professional | 53 · Discontinued | $0.87 | $0.87 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.66 Typical High $1.66 | Professional | 55 · Aftercare only | $0.66 | $0.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.44 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.44 | $0.44 | $1.10 |
Where Ohio sits
The same service costs 2.7 times more in Alaska than in Oklahoma. 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· 6th of 51
$5.37
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.