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 $5.62 Median $5.62 Typical High $30.20 | Facility | None | $5.62 | $5.62 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $22.91 | Professional | None | $5.62 | $5.62 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.07 | Facility | None | $0.02 | $0.03 | $0.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $6.17 Typical High $9.33 | Professional | None | $5.89 | $6.17 | $9.33 |
CareSource Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $17.78 | Facility | None | $13.18 | $13.18 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $7.08 | Professional | None | $6.17 | $6.17 | $7.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $17.78 | Facility | None | $13.18 | $13.18 | $17.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $10.23 | Professional | None | $6.17 | $6.17 | $10.23 |
Molina Setting Professional Modifier None Typical Low $6.76 Median $7.76 Typical High $8.91 | Professional | None | $6.76 | $7.76 | $8.91 |
United Setting Professional Modifier None Typical Low $12.30 Median $13.49 Typical High $26.92 | Professional | None | $12.30 | $13.49 | $26.92 |
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 $2.82 Median $2.82 Typical High $11.48 | Professional | 52 · Reduced service | $2.82 | $2.82 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $4.57 | Professional | 53 · Discontinued | $1.12 | $1.12 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $3.47 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $2.29 |
Where Ohio sits
The same service costs 2.1 times more in Iowa than in Montana. 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· 35th of 51
$6.17
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.