How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.22 Median $0.22 Typical High $0.22 | Facility | None | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.25 | Professional | None | $0.22 | $0.22 | $0.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.40 | Professional | None | $0.28 | $0.28 | $0.40 |
CareSource Setting Facility Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
Cigna Setting Facility Modifier None Typical Low $0.60 Median $0.60 Typical High $0.81 | Facility | None | $0.60 | $0.60 | $0.81 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.93 | Professional | None | $0.28 | $0.28 | $0.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $0.60 Median $0.60 Typical High $0.81 | Facility | None | $0.60 | $0.60 | $0.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.93 | Professional | None | $0.28 | $0.28 | $0.93 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.52 | Professional | None | $0.35 | $0.35 | $0.52 |
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 $0.11 Median $0.11 Typical High $7.59 | Professional | 52 · Reduced service | $0.11 | $0.11 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $3.02 | Professional | 53 · Discontinued | $0.04 | $0.04 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $2.24 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $1.51 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $1.51 |
Where Ohio sits
The same service costs 4.4 times more in Kansas than in Utah. 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· 34th of 51
$0.28
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.