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 $2.19 Median $5.37 Typical High $7.41 | Facility | None | $2.19 | $5.37 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.51 Typical High $21.88 | Professional | None | $2.19 | $2.51 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.57 Median $5.62 Typical High $15.49 | Facility | None | $2.57 | $5.62 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $4.68 | Professional | None | $2.19 | $2.19 | $4.68 |
Aultcare 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 Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
CareSource Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | None | $2.75 | $2.75 | $2.75 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.68 Typical High $7.24 | Facility | None | $4.17 | $4.68 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $4.90 | Professional | None | $2.19 | $2.19 | $4.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4.47 Median $6.31 Typical High $14.79 | Facility | None | $4.47 | $6.31 | $14.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $7.08 | Professional | None | $2.19 | $2.19 | $7.08 |
Molina Setting Professional Modifier None Typical Low $2.45 Median $3.02 Typical High $3.39 | Professional | None | $2.45 | $3.02 | $3.39 |
SummaCare Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $4.37 | Professional | None | $2.19 | $2.40 | $4.37 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $3.55 | Professional | None | $2.40 | $2.40 | $3.55 |
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 $0.33 Median $0.33 Typical High $3.31 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $2.19 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $2.19 |
Where Ohio sits
The same service costs 1.9 times more in Wyoming than in South Carolina. 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· 13th of 51
$2.45
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.