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 $0.76 Median $2.57 Typical High $4.57 | Facility | None | $0.76 | $2.57 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.91 Median $2.00 Typical High $5.50 | Facility | None | $0.91 | $2.00 | $5.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.74 Median $0.76 Typical High $1.58 | Professional | None | $0.74 | $0.76 | $1.58 |
CareSource 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 Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | None | $1.07 | $1.07 | $1.07 |
Cigna Setting Facility Modifier None Typical Low $1.45 Median $1.62 Typical High $2.51 | Facility | None | $1.45 | $1.62 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $3.47 | Professional | None | $0.76 | $0.76 | $3.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.62 Median $1.62 Typical High $2.19 | Facility | None | $1.62 | $1.62 | $2.19 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $3.47 | Professional | None | $0.76 | $0.76 | $3.47 |
Molina Setting Professional Modifier None Typical Low $0.71 Median $0.95 Typical High $1.20 | Professional | None | $0.71 | $0.95 | $1.20 |
SummaCare Setting Professional Modifier None Typical Low $0.76 Median $0.83 Typical High $1.51 | Professional | None | $0.76 | $0.83 | $1.51 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $1.26 | Professional | None | $0.85 | $0.85 | $1.26 |
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 $0.38 Median $0.38 Typical High $7.94 | Professional | 52 · Reduced service | $0.38 | $0.38 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $3.24 | Professional | 53 · Discontinued | $0.15 | $0.15 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $2.40 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $1.58 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $1.58 |
Where Ohio sits
The same service costs 3.9 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· 24th of 51
$0.85
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.