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 $3.55 Median $9.77 Typical High $33.11 | Facility | None | $3.55 | $9.77 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.80 Median $7.94 Typical High $22.91 | Facility | None | $3.80 | $7.94 | $22.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $7.41 | Professional | None | $3.55 | $3.55 | $7.41 |
Aultcare Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
CareSource Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
CareSource Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $6.76 Median $7.59 Typical High $11.75 | Facility | None | $6.76 | $7.59 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $9.55 | Professional | None | $3.55 | $3.55 | $9.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.46 Median $7.59 Typical High $10.23 | Facility | None | $6.46 | $7.59 | $10.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $9.55 | Professional | None | $3.55 | $3.55 | $9.55 |
Molina Setting Professional Modifier None Typical Low $3.72 Median $4.47 Typical High $5.01 | Professional | None | $3.72 | $4.47 | $5.01 |
SummaCare Setting Professional Modifier None Typical Low $3.55 Median $3.89 Typical High $7.08 | Professional | None | $3.55 | $3.89 | $7.08 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $5.01 | Professional | None | $3.39 | $3.39 | $5.01 |
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 $1.78 Median $1.78 Typical High $25.12 | Professional | 52 · Reduced service | $1.78 | $1.78 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $10.00 | Professional | 53 · Discontinued | $0.71 | $0.71 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $7.59 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $5.01 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $5.01 |
Where Ohio sits
The same service costs 4.0 times more in Oklahoma than in Maryland. 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· 24th 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.