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 $21.38 Median $53.70 Typical High $72.44 | Facility | None | $21.38 | $53.70 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $25.12 Typical High $66.07 | Professional | None | $21.38 | $25.12 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $33.88 Typical High $63.10 | Facility | None | $22.91 | $33.88 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $38.02 | Professional | None | $21.38 | $21.38 | $38.02 |
Aultcare Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
CareSource Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
CareSource Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $46.77 Typical High $70.79 | Facility | None | $40.74 | $46.77 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $40.74 | Professional | None | $21.38 | $21.38 | $40.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $29.51 Median $46.77 Typical High $69.18 | Facility | None | $29.51 | $46.77 | $69.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $37.15 | Professional | None | $21.38 | $21.38 | $37.15 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $26.92 Typical High $30.90 | Professional | None | $23.44 | $26.92 | $30.90 |
SummaCare Setting Professional Modifier None Typical Low $21.38 Median $23.99 Typical High $42.66 | Professional | None | $21.38 | $23.99 | $42.66 |
United Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
United Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $30.90 | Professional | None | $20.89 | $20.89 | $30.90 |
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 $10.72 Median $10.72 Typical High $26.30 | Professional | 52 · Reduced service | $10.72 | $10.72 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $10.72 | Professional | 53 · Discontinued | $4.37 | $4.37 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $7.94 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $5.25 |
Where Ohio sits
The same service costs 1.9 times more in Alaska 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· 5th of 51
$27.54
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.