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 $5.50 Median $5.50 Typical High $8.91 | Facility | None | $5.50 | $5.50 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $7.08 | Professional | None | $5.50 | $5.50 | $7.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.75 Median $8.51 Typical High $16.22 | Facility | None | $5.75 | $8.51 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $5.50 Typical High $9.33 | Professional | None | $5.37 | $5.50 | $9.33 |
CareSource Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
CareSource Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $10.47 Median $11.75 Typical High $18.20 | Facility | None | $10.47 | $11.75 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $6.92 | Professional | None | $5.50 | $5.50 | $6.92 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $10.00 Median $11.75 Typical High $15.85 | Facility | None | $10.00 | $11.75 | $15.85 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $6.92 | Professional | None | $5.50 | $5.50 | $6.92 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $6.92 Typical High $7.76 | Professional | None | $5.89 | $6.92 | $7.76 |
SummaCare Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $10.96 | Professional | None | $5.75 | $6.03 | $10.96 |
United Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $7.94 | Professional | None | $5.37 | $5.37 | $7.94 |
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 $2.75 Median $2.75 Typical High $3.47 | Professional | 52 · Reduced service | $2.75 | $2.75 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.41 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $1.05 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.71 |
Where Ohio sits
The same service costs 1.7 times more in Alaska than in Nebraska. 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· 5th of 51
$6.46
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.