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 $4.27 Median $4.27 Typical High $39.81 | Facility | None | $4.27 | $4.27 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $30.20 | Professional | None | $4.27 | $4.27 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $10.96 Typical High $30.90 | Facility | None | $5.13 | $10.96 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $4.37 Typical High $8.91 | Professional | None | $4.27 | $4.37 | $8.91 |
CareSource Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
CareSource Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $9.12 Typical High $14.13 | Facility | None | $7.94 | $9.12 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $11.48 | Professional | None | $4.27 | $4.27 | $11.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $8.91 Median $9.12 Typical High $12.30 | Facility | None | $8.91 | $9.12 | $12.30 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $11.48 | Professional | None | $4.27 | $4.27 | $11.48 |
Molina Setting Professional Modifier None Typical Low $5.25 Median $5.89 Typical High $7.59 | Professional | None | $5.25 | $5.89 | $7.59 |
SummaCare Setting Professional Modifier None Typical Low $4.27 Median $4.68 Typical High $8.51 | Professional | None | $4.27 | $4.68 | $8.51 |
United Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $7.08 | Professional | None | $4.68 | $4.68 | $7.08 |
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 $2.14 Median $2.14 Typical High $15.14 | Professional | 52 · Reduced service | $2.14 | $2.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $6.03 | Professional | 53 · Discontinued | $0.85 | $0.85 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.63 Typical High $4.47 | Professional | 55 · Aftercare only | $0.63 | $0.63 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $3.02 |
Where Ohio sits
The same service costs 3.4 times more in Texas 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· 37th of 51
$4.68
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.