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 $20.89 Median $44.67 Typical High $70.79 | Facility | None | $20.89 | $44.67 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $117.49 | Professional | None | $20.89 | $21.38 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $38.02 Typical High $66.07 | Facility | None | $22.91 | $38.02 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $41.69 | Professional | None | $20.89 | $21.88 | $41.69 |
Aultcare Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
CareSource Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $45.71 Typical High $69.18 | Facility | None | $39.81 | $45.71 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $45.71 | Professional | None | $20.89 | $20.89 | $45.71 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $30.90 Median $45.71 Typical High $64.57 | Facility | None | $30.90 | $45.71 | $64.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $45.71 | Professional | None | $20.89 | $20.89 | $45.71 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $28.84 Typical High $31.62 | Professional | None | $23.99 | $28.84 | $31.62 |
SummaCare Setting Professional Modifier None Typical Low $20.89 Median $38.02 Typical High $41.69 | Professional | None | $20.89 | $38.02 | $41.69 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $32.36 | Professional | None | $21.88 | $21.88 | $32.36 |
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 $10.47 Median $10.47 Typical High $61.66 | Professional | 52 · Reduced service | $10.47 | $10.47 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $24.55 | Professional | 53 · Discontinued | $4.27 | $4.27 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $18.20 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $12.30 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $12.30 |
Where Ohio sits
The same service costs 2.6 times more in Wyoming than in Texas. 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· 5th of 51
$28.18
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.