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 $0.89 Median $0.89 Typical High $1.00 | Facility | None | $0.89 | $0.89 | $1.00 |
Aetna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.10 Median $2.40 Typical High $6.61 | Facility | None | $1.10 | $2.40 | $6.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $1.66 | Professional | None | $0.89 | $0.89 | $1.66 |
CareSource Setting Facility Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Facility | None | $0.95 | $0.95 | $0.95 |
CareSource Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $1.95 Typical High $2.95 | Facility | None | $1.70 | $1.95 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $1.20 | Professional | None | $0.89 | $0.89 | $1.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.91 Median $1.95 Typical High $2.57 | Facility | None | $1.91 | $1.95 | $2.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $3.47 | Professional | None | $0.89 | $0.89 | $3.47 |
Molina Setting Professional Modifier None Typical Low $1.07 Median $1.26 Typical High $1.45 | Professional | None | $1.07 | $1.26 | $1.45 |
SummaCare Setting Professional Modifier None Typical Low $0.89 Median $1.00 Typical High $1.78 | Professional | None | $0.89 | $1.00 | $1.78 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.51 | Professional | None | $1.02 | $1.02 | $1.51 |
2 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 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $2.51 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $1.70 |
Where Ohio sits
The same service costs 2.3 times more in South Carolina than in North Dakota. 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· 39th of 51
$1.00
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.