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 $1.74 Median $1.74 Typical High $3.02 | Facility | None | $1.74 | $1.74 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.00 | Professional | None | $1.74 | $1.74 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.82 Median $2.69 Typical High $5.13 | Facility | None | $1.82 | $2.69 | $5.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.58 Median $1.74 Typical High $3.24 | Professional | None | $1.58 | $1.74 | $3.24 |
CareSource Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
CareSource Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $3.31 Median $3.80 Typical High $5.75 | Facility | None | $3.31 | $3.80 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.86 | Professional | None | $1.74 | $1.74 | $1.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3.24 Median $3.80 Typical High $5.01 | Facility | None | $3.24 | $3.80 | $5.01 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.86 | Professional | None | $1.74 | $1.74 | $1.86 |
Molina Setting Professional Modifier None Typical Low $1.86 Median $2.19 Typical High $2.45 | Professional | None | $1.86 | $2.19 | $2.45 |
SummaCare Setting Professional Modifier None Typical Low $1.82 Median $1.95 Typical High $3.47 | Professional | None | $1.82 | $1.95 | $3.47 |
United Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
United Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.51 | Professional | None | $1.70 | $1.70 | $2.51 |
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 $0.87 Median $0.87 Typical High $1.00 | Professional | 52 · Reduced service | $0.87 | $0.87 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $0.35 Typical High $0.40 | Professional | 53 · Discontinued | $0.35 | $0.35 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.26 Typical High $0.30 | Professional | 55 · Aftercare only | $0.26 | $0.26 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.20 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in Mississippi. 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· 10th 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.