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 $3.63 Median $4.79 Typical High $7.08 | Facility | None | $3.63 | $4.79 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.89 Typical High $19.05 | Professional | None | $3.63 | $3.89 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.89 Median $8.51 Typical High $23.44 | Facility | None | $3.89 | $8.51 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.63 Typical High $5.75 | Professional | None | $3.09 | $3.63 | $5.75 |
Aultcare Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
CareSource Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Facility | None | $2.95 | $2.95 | $2.95 |
CareSource Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $7.76 Typical High $12.02 | Facility | None | $6.92 | $7.76 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | None | $3.63 | $3.63 | $4.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.24 Median $6.31 Typical High $13.80 | Facility | None | $2.24 | $6.31 | $13.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $5.89 | Professional | None | $3.63 | $3.63 | $5.89 |
Molina Setting Professional Modifier None Typical Low $3.98 Median $4.68 Typical High $5.62 | Professional | None | $3.98 | $4.68 | $5.62 |
SummaCare Setting Professional Modifier None Typical Low $3.63 Median $3.98 Typical High $7.24 | Professional | None | $3.63 | $3.98 | $7.24 |
United Setting Professional Modifier None Typical Low $3.31 Median $3.72 Typical High $7.24 | Professional | None | $3.31 | $3.72 | $7.24 |
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 $1.82 Median $1.82 Typical High $10.00 | Professional | 52 · Reduced service | $1.82 | $1.82 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $3.98 | Professional | 53 · Discontinued | $0.72 | $0.72 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $0.55 Typical High $3.02 | Professional | 55 · Aftercare only | $0.55 | $0.55 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $2.00 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $2.00 |
Where Ohio sits
The same service costs 2.5 times more in Alaska 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· 16th of 51
$3.80
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.