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 $5.50 Median $5.50 Typical High $23.99 | Facility | None | $5.50 | $5.50 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $15.14 | Professional | None | $5.50 | $5.50 | $15.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.89 Median $9.55 Typical High $16.60 | Facility | None | $5.89 | $9.55 | $16.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $8.91 | Professional | None | $5.50 | $5.50 | $8.91 |
CareSource Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
CareSource Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $11.75 Typical High $18.20 | Facility | None | $5.37 | $11.75 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $7.08 | Professional | None | $5.50 | $5.50 | $7.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.37 Median $11.75 Typical High $15.85 | Facility | None | $5.37 | $11.75 | $15.85 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $7.08 | Professional | None | $5.50 | $5.50 | $7.08 |
Molina Setting Professional Modifier None Typical Low $6.03 Median $6.92 Typical High $7.94 | Professional | None | $6.03 | $6.92 | $7.94 |
SummaCare Setting Professional Modifier None Typical Low $5.50 Median $6.03 Typical High $10.96 | Professional | None | $5.50 | $6.03 | $10.96 |
United Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $5.50 Median $6.17 Typical High $12.02 | Professional | None | $5.50 | $6.17 | $12.02 |
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 $2.75 Median $2.75 Typical High $7.59 | Professional | 52 · Reduced service | $2.75 | $2.75 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $3.02 | Professional | 53 · Discontinued | $1.10 | $1.10 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.81 Typical High $2.24 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $1.51 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $1.51 |
Where Ohio sits
The same service costs 1.9 times more in Alaska than in New Mexico. 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· 11th of 51
$6.31
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.