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 $1.58 Median $4.17 Typical High $5.37 | Facility | None | $1.58 | $4.17 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $3.98 | Professional | None | $1.58 | $1.58 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.70 Median $2.51 Typical High $4.79 | Facility | None | $1.70 | $2.51 | $4.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.95 | Professional | None | $1.58 | $1.58 | $2.95 |
CareSource 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 Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $3.39 Typical High $5.25 | Facility | None | $2.95 | $3.39 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.34 | Professional | None | $1.58 | $1.58 | $2.34 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.95 Median $3.39 Typical High $4.57 | Facility | None | $2.95 | $3.39 | $4.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.40 | Professional | None | $1.58 | $1.58 | $2.40 |
Molina Setting Professional Modifier None Typical Low $1.74 Median $2.00 Typical High $2.29 | Professional | None | $1.74 | $2.00 | $2.29 |
SummaCare Setting Professional Modifier None Typical Low $1.66 Median $1.74 Typical High $3.16 | Professional | None | $1.66 | $1.74 | $3.16 |
United Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.34 | Professional | None | $1.58 | $1.58 | $2.34 |
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 $0.79 Median $0.79 Typical High $2.00 | Professional | 52 · Reduced service | $0.79 | $0.79 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.79 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.60 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.40 |
Where Ohio sits
The same service costs 1.7 times more in Arizona 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· 6th 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.