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 $3.47 Median $3.47 Typical High $6.03 | Facility | None | $3.47 | $3.47 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $5.01 | Professional | None | $3.47 | $3.47 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $5.62 Typical High $10.47 | Facility | None | $3.55 | $5.62 | $10.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $6.61 | Professional | None | $3.47 | $3.47 | $6.61 |
CareSource Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
CareSource Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $6.61 Median $7.41 Typical High $11.48 | Facility | None | $6.61 | $7.41 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $4.57 | Professional | None | $3.47 | $3.47 | $4.57 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.17 Median $7.41 Typical High $10.00 | Facility | None | $6.17 | $7.41 | $10.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $4.57 | Professional | None | $3.47 | $3.47 | $4.57 |
Molina Setting Professional Modifier None Typical Low $3.55 Median $4.37 Typical High $4.79 | Professional | None | $3.55 | $4.37 | $4.79 |
SummaCare Setting Professional Modifier None Typical Low $3.47 Median $3.80 Typical High $6.92 | Professional | None | $3.47 | $3.80 | $6.92 |
United Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.79 | Professional | None | $3.24 | $3.24 | $4.79 |
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 $1.74 Median $1.74 Typical High $2.51 | Professional | 52 · Reduced service | $1.74 | $1.74 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.69 Typical High $1.00 | Professional | 53 · Discontinued | $0.69 | $0.69 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.76 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.50 |
Where Ohio sits
The same service costs 2.1 times more in Alaska 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· 7th of 51
$3.98
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.