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 $1.35 Median $2.45 Typical High $4.57 | Facility | None | $1.35 | $2.45 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.78 Typical High $4.57 | Professional | None | $1.35 | $1.78 | $4.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.48 Median $3.16 Typical High $8.91 | Facility | None | $1.48 | $3.16 | $8.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $2.29 | Professional | None | $1.35 | $1.35 | $2.29 |
Aultcare Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Facility | None | $1.82 | $1.82 | $1.82 |
CareSource Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
CareSource Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | None | $1.70 | $1.70 | $1.70 |
Cigna Setting Facility Modifier None Typical Low $2.51 Median $2.88 Typical High $4.47 | Facility | None | $2.51 | $2.88 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $5.01 | Professional | None | $1.35 | $1.35 | $5.01 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.69 Median $5.50 Typical High $11.22 | Facility | None | $2.69 | $5.50 | $11.22 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $6.76 | Professional | None | $1.35 | $1.35 | $6.76 |
Molina Setting Professional Modifier None Typical Low $1.48 Median $1.70 Typical High $2.14 | Professional | None | $1.48 | $1.70 | $2.14 |
SummaCare Setting Professional Modifier None Typical Low $1.35 Median $1.48 Typical High $2.69 | Professional | None | $1.35 | $1.48 | $2.69 |
United Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.86 | Professional | None | $1.35 | $1.35 | $1.86 |
5 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 $0.68 Median $0.68 Typical High $4.47 | Professional | 52 · Reduced service | $0.68 | $0.68 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $1.82 | Professional | 53 · Discontinued | $0.27 | $0.27 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $1.35 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.89 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | JZ · No drug discarded | $1.78 | $1.78 | $1.78 |
Where Ohio sits
The same service costs 3.2 times more in Wyoming than in Maine. 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· 8th of 51
$1.55
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.