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 $1.66 Median $3.31 Typical High $6.17 | Facility | None | $1.66 | $3.31 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $1.91 Typical High $6.17 | Professional | None | $1.66 | $1.91 | $6.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.04 Median $4.37 Typical High $12.02 | Facility | None | $2.04 | $4.37 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.66 Median $1.70 Typical High $3.02 | Professional | None | $1.66 | $1.70 | $3.02 |
Aultcare Setting Facility Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
CareSource 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 Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.55 Typical High $5.50 | Facility | None | $3.09 | $3.55 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $5.37 | Professional | None | $1.66 | $1.66 | $5.37 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3.55 Median $4.79 Typical High $8.71 | Facility | None | $3.55 | $4.79 | $8.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $7.41 | Professional | None | $1.66 | $1.66 | $7.41 |
Molina Setting Professional Modifier None Typical Low $1.95 Median $2.29 Typical High $2.63 | Professional | None | $1.95 | $2.29 | $2.63 |
SummaCare Setting Professional Modifier None Typical Low $1.66 Median $1.82 Typical High $3.31 | Professional | None | $1.66 | $1.82 | $3.31 |
United Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.57 | Professional | None | $1.86 | $1.86 | $2.57 |
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 $0.83 Median $0.83 Typical High $10.00 | Professional | 52 · Reduced service | $0.83 | $0.83 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.33 Typical High $6.17 | Professional | 53 · Discontinued | $0.33 | $0.33 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $4.68 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $3.09 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $3.09 |
Where Ohio sits
The same service costs 3.2 times more in Texas than in Georgia. 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· 15th of 51
$1.95
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.