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 $10.96 Median $37.15 Typical High $72.44 | Facility | None | $10.96 | $37.15 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $12.59 Typical High $58.88 | Professional | None | $10.96 | $12.59 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.02 Median $18.20 Typical High $33.88 | Facility | None | $12.02 | $18.20 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $23.44 | Professional | None | $10.96 | $11.22 | $23.44 |
CareSource Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
CareSource Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $23.99 Typical High $36.31 | Facility | None | $20.89 | $23.99 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $47.86 | Professional | None | $10.96 | $10.96 | $47.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21.38 Median $23.99 Typical High $31.62 | Facility | None | $21.38 | $23.99 | $31.62 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $47.86 | Professional | None | $10.96 | $10.96 | $47.86 |
Molina Setting Professional Modifier None Typical Low $12.30 Median $14.45 Typical High $16.22 | Professional | None | $12.30 | $14.45 | $16.22 |
SummaCare Setting Professional Modifier None Typical Low $10.96 Median $19.05 Typical High $21.88 | Professional | None | $10.96 | $19.05 | $21.88 |
United Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $16.60 | Professional | None | $11.22 | $11.22 | $16.60 |
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 $5.50 Median $5.50 Typical High $24.55 | Professional | 52 · Reduced service | $5.50 | $5.50 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $9.77 | Professional | 53 · Discontinued | $2.19 | $2.19 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $7.41 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $4.90 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $4.90 |
Where Ohio sits
The same service costs 3.7 times more in Wyoming than in Georgia. 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· 7th of 51
$14.13
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.