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 $3.72 Median $3.72 Typical High $10.00 | Facility | None | $3.72 | $3.72 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $7.94 | Professional | None | $3.72 | $3.72 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.89 Median $5.75 Typical High $10.96 | Facility | None | $3.89 | $5.75 | $10.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $3.72 Typical High $6.31 | Professional | None | $3.63 | $3.72 | $6.31 |
CareSource Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
CareSource Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.94 Typical High $12.30 | Facility | None | $7.08 | $7.94 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $4.79 | Professional | None | $3.72 | $3.72 | $4.79 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.76 Median $7.94 Typical High $10.72 | Facility | None | $6.76 | $7.94 | $10.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $4.79 | Professional | None | $3.72 | $3.72 | $4.79 |
Molina Setting Professional Modifier None Typical Low $3.98 Median $4.68 Typical High $5.25 | Professional | None | $3.98 | $4.68 | $5.25 |
SummaCare Setting Professional Modifier None Typical Low $3.89 Median $4.07 Typical High $7.41 | Professional | None | $3.89 | $4.07 | $7.41 |
United Setting Facility Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $5.37 | Professional | None | $3.55 | $3.55 | $5.37 |
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 $1.86 Median $1.86 Typical High $3.98 | Professional | 52 · Reduced service | $1.86 | $1.86 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.74 Typical High $1.58 | Professional | 53 · Discontinued | $0.74 | $0.74 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $1.20 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.37 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.37 | $0.37 | $0.79 |
Where Ohio sits
The same service costs 1.9 times more in Alaska 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· 4th of 51
$4.47
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.