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 $2.69 Median $2.69 Typical High $19.05 | Facility | None | $2.69 | $2.69 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $19.05 | Professional | None | $2.69 | $2.69 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.88 Median $6.03 Typical High $17.38 | Facility | None | $2.88 | $6.03 | $17.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $5.01 | Professional | None | $2.69 | $2.69 | $5.01 |
CareSource Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
CareSource Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $5.75 Typical High $8.91 | Facility | None | $5.13 | $5.75 | $8.91 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $3.16 | Professional | None | $2.69 | $2.69 | $3.16 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4.90 Median $5.75 Typical High $7.76 | Facility | None | $4.90 | $5.75 | $7.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $3.16 | Professional | None | $2.69 | $2.69 | $3.16 |
Molina Setting Professional Modifier None Typical Low $2.88 Median $3.39 Typical High $3.80 | Professional | None | $2.88 | $3.39 | $3.80 |
SummaCare Setting Professional Modifier None Typical Low $2.69 Median $2.95 Typical High $5.37 | Professional | None | $2.69 | $2.95 | $5.37 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.89 | Professional | None | $2.57 | $2.57 | $3.89 |
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 $1.35 Median $1.35 Typical High $9.55 | Professional | 52 · Reduced service | $1.35 | $1.35 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.54 Typical High $3.80 | Professional | 53 · Discontinued | $0.54 | $0.54 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.40 Typical High $2.82 | Professional | 55 · Aftercare only | $0.40 | $0.40 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $1.91 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $1.91 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 19th of 51
$2.69
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.