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 $2.95 Median $5.37 Typical High $9.55 | Facility | None | $2.95 | $5.37 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $20.89 | Professional | None | $2.82 | $2.82 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $6.92 Typical High $19.05 | Facility | None | $3.24 | $6.92 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $5.37 | Professional | None | $2.82 | $2.82 | $5.37 |
Aultcare Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
CareSource Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | None | $7.41 | $7.41 | $7.41 |
CareSource Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $6.03 Typical High $9.33 | Facility | None | $5.37 | $6.03 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.62 Median $6.03 Typical High $8.91 | Facility | None | $5.62 | $6.03 | $8.91 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Molina Setting Professional Modifier None Typical Low $3.09 Median $3.55 Typical High $4.17 | Professional | None | $3.09 | $3.55 | $4.17 |
SummaCare Setting Professional Modifier None Typical Low $2.82 Median $3.09 Typical High $5.62 | Professional | None | $2.82 | $3.09 | $5.62 |
United Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $4.37 | Professional | None | $2.95 | $2.95 | $4.37 |
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 $1.41 Median $1.41 Typical High $10.47 | Professional | 52 · Reduced service | $1.41 | $1.41 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $4.17 | Professional | 53 · Discontinued | $0.56 | $0.56 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.42 Typical High $3.16 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $2.09 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $2.09 |
Where Ohio sits
The same service costs 7.4 times more in Wyoming than in Kansas. 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· 17th of 51
$3.09
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.