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 $3.09 Median $3.47 Typical High $15.85 | Facility | None | $3.09 | $3.47 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $15.85 | Professional | None | $3.09 | $3.09 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.39 Median $7.24 Typical High $20.42 | Facility | None | $3.39 | $7.24 | $20.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $6.46 | Professional | None | $3.09 | $3.09 | $6.46 |
CareSource Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
CareSource Setting Professional Modifier None Typical Low $2.88 Median $3.16 Typical High $4.27 | Professional | None | $2.88 | $3.16 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $6.61 Typical High $10.00 | Facility | None | $5.75 | $6.61 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $5.37 | Professional | None | $3.09 | $3.09 | $5.37 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.89 Median $6.61 Typical High $8.71 | Facility | None | $5.89 | $6.61 | $8.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $5.37 | Professional | None | $3.09 | $3.09 | $5.37 |
Molina Setting Professional Modifier None Typical Low $3.16 Median $3.47 Typical High $4.27 | Professional | None | $3.16 | $3.47 | $4.27 |
SummaCare Setting Professional Modifier None Typical Low $3.09 Median $3.24 Typical High $5.89 | Professional | None | $3.09 | $3.24 | $5.89 |
United Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $4.17 | Professional | None | $1.26 | $3.16 | $4.17 |
2 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 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $2.40 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $1.58 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $1.58 |
Where Ohio sits
The same service costs 3.5 times more in Oklahoma than in Virginia. 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· 45th of 51
$3.09
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.