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 $8.13 Median $13.49 Typical High $27.54 | Facility | None | $8.13 | $13.49 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.91 Typical High $27.54 | Professional | None | $8.13 | $8.91 | $27.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.61 Median $17.38 Typical High $52.48 | Facility | None | $6.61 | $17.38 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.17 Median $8.13 Typical High $12.30 | Professional | None | $6.17 | $8.13 | $12.30 |
Aultcare Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
CareSource Setting Facility Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
CareSource Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $17.38 Typical High $26.92 | Facility | None | $15.14 | $17.38 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3.09 Median $8.32 Typical High $30.90 | Facility | None | $3.09 | $8.32 | $30.90 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Molina Setting Professional Modifier None Typical Low $3.80 Median $5.62 Typical High $11.22 | Professional | None | $3.80 | $5.62 | $11.22 |
SummaCare Setting Professional Modifier None Typical Low $8.13 Median $8.91 Typical High $16.22 | Professional | None | $8.13 | $8.91 | $16.22 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $6.61 | Professional | None | $4.47 | $4.47 | $6.61 |
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 $4.07 Median $4.07 Typical High $15.14 | Professional | 52 · Reduced service | $4.07 | $4.07 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $6.03 | Professional | 53 · Discontinued | $1.62 | $1.62 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $4.47 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $3.02 |
Where Ohio sits
The same service costs 10.7 times more in Minnesota 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· 26th of 51
$8.13
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.