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 $3.24 Median $6.03 Typical High $22.91 | Facility | None | $3.24 | $6.03 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $22.91 | Professional | None | $3.24 | $3.24 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $7.59 Typical High $20.89 | Facility | None | $3.55 | $7.59 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.75 Median $3.24 Typical High $5.13 | Professional | None | $2.75 | $3.24 | $5.13 |
Aultcare Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
CareSource Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Facility | None | $3.09 | $3.09 | $3.09 |
CareSource Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.92 Typical High $10.72 | Facility | None | $6.17 | $6.92 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.89 | Professional | None | $3.24 | $3.24 | $3.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.03 Median $6.92 Typical High $10.47 | Facility | None | $6.03 | $6.92 | $10.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.89 | Professional | None | $3.24 | $3.24 | $3.89 |
Molina Setting Professional Modifier None Typical Low $4.57 Median $6.31 Typical High $6.76 | Professional | None | $4.57 | $6.31 | $6.76 |
SummaCare Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $6.46 | Professional | None | $3.24 | $3.55 | $6.46 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $4.68 | Professional | None | $3.16 | $3.16 | $4.68 |
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 $1.62 Median $1.62 Typical High $11.48 | Professional | 52 · Reduced service | $1.62 | $1.62 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $4.57 | Professional | 53 · Discontinued | $0.65 | $0.65 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $3.47 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $2.29 |
Where Ohio sits
The same service costs 2.0 times more in Arizona than in Oklahoma. 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· 15th of 51
$3.31
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.