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 $1.51 Median $1.51 Typical High $10.96 | Facility | None | $1.51 | $1.51 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $8.91 | Professional | None | $1.51 | $1.51 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.51 Median $2.45 Typical High $3.80 | Facility | None | $1.51 | $2.45 | $3.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $2.82 | Professional | None | $1.51 | $1.51 | $2.82 |
CareSource Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
CareSource Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $3.24 Typical High $5.01 | Facility | None | $2.88 | $3.24 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.74 | Professional | None | $1.51 | $1.51 | $1.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.88 Median $3.24 Typical High $4.37 | Facility | None | $2.88 | $3.24 | $4.37 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.74 | Professional | None | $1.51 | $1.51 | $1.74 |
Molina Setting Professional Modifier None Typical Low $1.66 Median $1.91 Typical High $2.19 | Professional | None | $1.66 | $1.91 | $2.19 |
SummaCare Setting Professional Modifier None Typical Low $1.51 Median $1.66 Typical High $3.02 | Professional | None | $1.51 | $1.66 | $3.02 |
United Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $2.24 | Professional | None | $1.51 | $1.51 | $2.24 |
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 $0.76 Median $0.76 Typical High $4.47 | Professional | 52 · Reduced service | $0.76 | $0.76 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.30 Typical High $1.82 | Professional | 53 · Discontinued | $0.30 | $0.30 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $1.35 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.89 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in North 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· 12th of 51
$1.70
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.