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 $13.18 Typical High $29.51 | Facility | None | $4.37 | $13.18 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $39.81 | Professional | None | $3.89 | $3.89 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.89 Median $11.75 Typical High $25.70 | Facility | None | $5.89 | $11.75 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.31 Median $3.89 Typical High $10.47 | Professional | None | $3.31 | $3.89 | $10.47 |
Aultcare Setting Facility Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Facility | None | $5.25 | $5.25 | $5.25 |
CareSource Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
CareSource Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $8.32 Typical High $12.88 | Facility | None | $7.41 | $8.32 | $12.88 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $7.08 | Professional | None | $3.89 | $3.89 | $7.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $8.32 Median $11.22 Typical High $20.42 | Facility | None | $8.32 | $11.22 | $20.42 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $7.08 | Professional | None | $3.89 | $3.89 | $7.08 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $12.02 Typical High $14.45 | Professional | None | $4.90 | $12.02 | $14.45 |
SummaCare Setting Professional Modifier None Typical Low $3.89 Median $4.27 Typical High $7.76 | Professional | None | $3.89 | $4.27 | $7.76 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $15.49 | Professional | None | $10.47 | $10.47 | $15.49 |
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 $1.95 Median $1.95 Typical High $19.95 | Professional | 52 · Reduced service | $1.95 | $1.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $7.94 | Professional | 53 · Discontinued | $0.78 | $0.78 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.59 Typical High $6.03 | Professional | 55 · Aftercare only | $0.59 | $0.59 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $3.98 | Professional | 56 · Pre-op care only | $0.39 | $0.39 | $3.98 |
Where Ohio sits
The same service costs 3.2 times more in Hawaii than in Georgia. 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· 34th of 51
$5.13
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.