How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.78 Median $2.24 Typical High $3.24 | Professional | None | $1.78 | $2.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $6.46 | Facility | None | $4.79 | $4.79 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.63 | Professional | None | $2.24 | $2.24 | $2.63 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $6.46 | Facility | None | $4.79 | $4.79 | $6.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.63 | Professional | None | $2.24 | $2.24 | $2.63 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $3.31 | Professional | None | $2.24 | $2.24 | $3.31 |
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 $1.07 Median $1.07 Typical High $1.07 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.42 Typical High $10.00 | Professional | 53 · Discontinued | $0.42 | $0.42 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $7.59 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $5.01 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $5.01 |
Where Ohio sits
The same service costs 128.8 times more in Kansas than in New York. 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· 44th of 51
$2.24
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.