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 $0.60 Median $2.14 Typical High $6.46 | Facility | None | $0.60 | $2.14 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $2.14 | Professional | None | $1.91 | $1.91 | $2.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.34 Median $5.01 Typical High $14.13 | Facility | None | $2.34 | $5.01 | $14.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $4.07 | Professional | None | $1.91 | $1.91 | $4.07 |
Aultcare Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
CareSource Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
CareSource Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $4.07 Typical High $6.31 | Facility | None | $3.63 | $4.07 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $5.01 | Professional | None | $1.91 | $1.91 | $5.01 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3.47 Median $4.07 Typical High $11.22 | Facility | None | $3.47 | $4.07 | $11.22 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $7.24 | Professional | None | $1.91 | $1.91 | $7.24 |
Molina Setting Professional Modifier None Typical Low $2.09 Median $2.69 Typical High $3.02 | Professional | None | $2.09 | $2.69 | $3.02 |
SummaCare Setting Professional Modifier None Typical Low $1.91 Median $2.09 Typical High $3.80 | Professional | None | $1.91 | $2.09 | $3.80 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.24 | Professional | None | $2.14 | $2.14 | $3.24 |
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 $0.95 Median $0.95 Typical High $15.14 | Professional | 52 · Reduced service | $0.95 | $0.95 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.38 Typical High $6.03 | Professional | 53 · Discontinued | $0.38 | $0.38 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $4.47 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $3.02 |
Where Ohio sits
The same service costs 2.5 times more in Texas than in South Carolina. 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· 31st of 51
$2.14
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.