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 $1.41 Median $1.41 Typical High $3.98 | Facility | None | $1.41 | $1.41 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $3.02 | Professional | None | $1.41 | $1.41 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.48 Median $2.19 Typical High $4.17 | Facility | None | $1.48 | $2.19 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.41 Typical High $2.57 | Professional | None | $1.38 | $1.41 | $2.57 |
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 $2.63 Median $3.02 Typical High $4.57 | Facility | None | $2.63 | $3.02 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $2.14 | Professional | None | $1.41 | $1.41 | $2.14 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.57 Median $3.02 Typical High $3.98 | Facility | None | $2.57 | $3.02 | $3.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $2.14 | Professional | None | $1.41 | $1.41 | $2.14 |
Molina Setting Professional Modifier None Typical Low $1.51 Median $1.74 Typical High $2.00 | Professional | None | $1.51 | $1.74 | $2.00 |
SummaCare Setting Professional Modifier None Typical Low $1.48 Median $1.55 Typical High $2.82 | Professional | None | $1.48 | $1.55 | $2.82 |
United Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $2.04 | Professional | None | $1.38 | $1.38 | $2.04 |
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 $0.71 Median $0.71 Typical High $1.51 | Professional | 52 · Reduced service | $0.71 | $0.71 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.60 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.45 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.30 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 11th of 51
$1.62
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.