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 $2.04 Typical High $2.57 | Facility | None | $0.60 | $2.04 | $2.57 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $10.00 | Professional | None | $0.60 | $0.60 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.65 Median $1.29 Typical High $4.07 | Facility | None | $0.65 | $1.29 | $4.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $1.26 | Professional | None | $0.60 | $0.60 | $1.26 |
Aultcare Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Facility | None | $0.79 | $0.79 | $0.79 |
CareSource Setting Facility Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Facility | None | $0.62 | $0.62 | $0.62 |
CareSource Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | None | $0.81 | $0.81 | $0.81 |
Cigna Setting Facility Modifier None Typical Low $1.12 Median $1.29 Typical High $1.95 | Facility | None | $1.12 | $1.29 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $2.40 | Professional | None | $0.60 | $0.60 | $2.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.17 Median $1.29 Typical High $1.82 | Facility | None | $1.17 | $1.29 | $1.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $3.47 | Professional | None | $0.60 | $0.60 | $3.47 |
Molina Setting Professional Modifier None Typical Low $0.68 Median $0.83 Typical High $0.91 | Professional | None | $0.68 | $0.83 | $0.91 |
SummaCare Setting Professional Modifier None Typical Low $0.60 Median $0.66 Typical High $1.20 | Professional | None | $0.60 | $0.66 | $1.20 |
United Setting Professional Modifier None Typical Low $0.62 Median $0.69 Typical High $1.35 | Professional | None | $0.62 | $0.69 | $1.35 |
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 $0.30 Median $0.30 Typical High $5.50 | Professional | 52 · Reduced service | $0.30 | $0.30 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $2.19 | Professional | 53 · Discontinued | $0.12 | $0.12 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $1.66 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $1.10 |
Where Ohio sits
The same service costs 3.4 times more in Wyoming than in Delaware. 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· 20th of 51
$0.68
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.