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 $1.48 Median $1.48 Typical High $5.01 | Facility | None | $1.48 | $1.48 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $3.98 | Professional | None | $1.48 | $1.48 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.62 Median $2.45 Typical High $4.57 | Facility | None | $1.62 | $2.45 | $4.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $2.75 | Professional | None | $1.48 | $1.48 | $2.75 |
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 $2.82 Median $3.24 Typical High $4.90 | Facility | None | $2.82 | $3.24 | $4.90 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.82 | Professional | None | $1.48 | $1.48 | $1.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.88 Median $3.24 Typical High $4.27 | Facility | None | $2.88 | $3.24 | $4.27 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.82 | Professional | None | $1.48 | $1.48 | $1.82 |
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 $1.55 Median $1.62 Typical High $2.95 | Professional | None | $1.55 | $1.62 | $2.95 |
United Setting Facility Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Facility | None | $1.48 | $1.48 | $1.48 |
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 $2.00 | Professional | 52 · Reduced service | $0.76 | $0.76 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.30 Typical High $0.79 | Professional | 53 · Discontinued | $0.30 | $0.30 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.22 Typical High $0.60 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.40 |
Where Ohio sits
The same service costs 1.5 times more in Alaska than in Alabama. 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· 4th of 51
$1.82
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.