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 $0.55 Median $0.55 Typical High $5.01 | Facility | None | $0.55 | $0.55 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $3.98 | Professional | None | $0.55 | $0.55 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.59 Median $1.20 Typical High $3.55 | Facility | None | $0.59 | $1.20 | $3.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.46 Median $0.55 Typical High $1.15 | Professional | None | $0.46 | $0.55 | $1.15 |
CareSource Setting Facility Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Facility | None | $0.45 | $0.45 | $0.45 |
CareSource Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
Cigna Setting Facility Modifier None Typical Low $1.02 Median $1.17 Typical High $1.78 | Facility | None | $1.02 | $1.17 | $1.78 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $1.02 | Professional | None | $0.55 | $0.55 | $1.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $0.79 Median $1.17 Typical High $1.58 | Facility | None | $0.79 | $1.17 | $1.58 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $1.02 | Professional | None | $0.55 | $0.55 | $1.02 |
Molina Setting Professional Modifier None Typical Low $0.52 Median $0.69 Typical High $0.83 | Professional | None | $0.52 | $0.69 | $0.83 |
SummaCare Setting Professional Modifier None Typical Low $0.55 Median $0.62 Typical High $1.10 | Professional | None | $0.55 | $0.62 | $1.10 |
United Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.62 | Professional | None | $0.42 | $0.42 | $0.62 |
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 $0.28 Median $0.28 Typical High $2.00 | Professional | 52 · Reduced service | $0.28 | $0.28 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.79 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.60 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.40 |
Where Ohio sits
The same service costs 2.1 times more in Arizona than in Maryland. 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· 39th of 51
$0.55
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.