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 $5.62 Median $19.05 Typical High $58.88 | Facility | None | $5.62 | $19.05 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.31 Median $13.80 Typical High $38.02 | Facility | None | $6.31 | $13.80 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $11.75 | Professional | None | $5.62 | $5.62 | $11.75 |
Aultcare Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
CareSource Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
CareSource Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $10.47 Median $12.02 Typical High $18.62 | Facility | None | $10.47 | $12.02 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $19.50 | Professional | None | $5.62 | $5.62 | $19.50 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $10.96 Median $12.02 Typical High $16.22 | Facility | None | $10.96 | $12.02 | $16.22 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $19.50 | Professional | None | $5.62 | $5.62 | $19.50 |
Molina Setting Professional Modifier None Typical Low $6.46 Median $8.13 Typical High $12.88 | Professional | None | $6.46 | $8.13 | $12.88 |
SummaCare Setting Professional Modifier None Typical Low $5.62 Median $6.17 Typical High $11.22 | Professional | None | $5.62 | $6.17 | $11.22 |
United Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $8.71 | Professional | None | $5.89 | $5.89 | $8.71 |
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 $2.82 Median $2.82 Typical High $34.67 | Professional | 52 · Reduced service | $2.82 | $2.82 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $14.13 | Professional | 53 · Discontinued | $1.12 | $1.12 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $10.47 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $7.08 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $7.08 |
Where Ohio sits
The same service costs 3.2 times more in Oklahoma than in North Dakota. 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· 26th of 51
$6.03
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.