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 $0.85 Median $0.85 Typical High $3.02 | Facility | None | $0.85 | $0.85 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $3.02 | Professional | None | $0.85 | $0.85 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.00 Median $1.78 Typical High $2.88 | Facility | None | $1.00 | $1.78 | $2.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $0.85 Typical High $1.82 | Professional | None | $0.79 | $0.85 | $1.82 |
CareSource Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Facility | None | $0.79 | $0.79 | $0.79 |
CareSource Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | None | $1.07 | $1.07 | $1.07 |
Cigna Setting Facility Modifier None Typical Low $1.62 Median $1.86 Typical High $2.88 | Facility | None | $1.62 | $1.86 | $2.88 |
Cigna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $3.39 | Professional | None | $0.85 | $0.85 | $3.39 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.86 Median $1.91 Typical High $2.51 | Facility | None | $1.86 | $1.91 | $2.51 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $3.39 | Professional | None | $0.85 | $0.85 | $3.39 |
SummaCare Setting Professional Modifier None Typical Low $0.85 Median $0.95 Typical High $1.70 | Professional | None | $0.85 | $0.95 | $1.70 |
United Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Facility | None | $0.85 | $0.85 | $0.85 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.51 | Professional | None | $1.00 | $1.00 | $1.51 |
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 $0.43 Median $0.43 Typical High $1.51 | Professional | 52 · Reduced service | $0.43 | $0.43 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.60 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.45 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.30 |
Where Ohio sits
The same service costs 4.1 times more in Oklahoma than in North Dakota. 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· 11th of 51
$1.07
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.