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 $4.57 Median $12.30 Typical High $30.20 | Facility | None | $4.57 | $12.30 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $72.44 | Professional | None | $4.47 | $4.47 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.90 Median $10.47 Typical High $29.51 | Facility | None | $4.90 | $10.47 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $9.55 | Professional | None | $4.47 | $4.47 | $9.55 |
CareSource 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 Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $9.77 Typical High $14.79 | Facility | None | $8.51 | $9.77 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $12.02 | Professional | None | $4.47 | $4.47 | $12.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.41 Median $9.77 Typical High $22.39 | Facility | None | $1.41 | $9.77 | $22.39 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $12.02 | Professional | None | $4.47 | $4.47 | $12.02 |
Molina Setting Professional Modifier None Typical Low $5.01 Median $5.62 Typical High $6.61 | Professional | None | $5.01 | $5.62 | $6.61 |
SummaCare Setting Professional Modifier None Typical Low $4.47 Median $5.01 Typical High $8.91 | Professional | None | $4.47 | $5.01 | $8.91 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $6.17 | Professional | None | $4.17 | $4.17 | $6.17 |
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 $2.24 Median $2.24 Typical High $36.31 | Professional | 52 · Reduced service | $2.24 | $2.24 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.89 Typical High $14.45 | Professional | 53 · Discontinued | $0.89 | $0.89 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $10.72 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.45 Typical High $7.24 | Professional | 56 · Pre-op care only | $0.45 | $0.45 | $7.24 |
Where Ohio sits
The same service costs 7.9 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· 25th of 51
$4.90
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.