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 $1.23 Median $2.45 Typical High $4.07 | Facility | None | $1.23 | $2.45 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $3.39 | Professional | None | $1.23 | $1.23 | $3.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.38 Median $3.02 Typical High $8.32 | Facility | None | $1.38 | $3.02 | $8.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.02 Median $1.23 Typical High $2.00 | Professional | None | $1.02 | $1.23 | $2.00 |
Aultcare Setting Facility Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Facility | None | $1.62 | $1.62 | $1.62 |
CareSource Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
CareSource Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $2.57 Typical High $4.07 | Facility | None | $2.29 | $2.57 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $3.55 | Professional | None | $1.20 | $1.20 | $3.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.40 Median $2.69 Typical High $4.79 | Facility | None | $2.40 | $2.69 | $4.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $5.13 | Professional | None | $1.20 | $1.20 | $5.13 |
Molina Setting Professional Modifier None Typical Low $1.41 Median $1.62 Typical High $1.86 | Professional | None | $1.41 | $1.62 | $1.86 |
SummaCare Setting Professional Modifier None Typical Low $1.23 Median $1.35 Typical High $2.45 | Professional | None | $1.23 | $1.35 | $2.45 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.78 | Professional | None | $1.29 | $1.29 | $1.78 |
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 $0.62 Median $0.62 Typical High $7.08 | Professional | 52 · Reduced service | $0.62 | $0.62 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.24 Typical High $2.82 | Professional | 53 · Discontinued | $0.24 | $0.24 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $2.09 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $1.41 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $1.41 |
Where Ohio sits
The same service costs 3.4 times more in Texas than in Oklahoma. 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· 20th of 51
$1.32
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.