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 $4.68 Median $4.68 Typical High $7.94 | Facility | None | $4.68 | $4.68 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.03 | Professional | None | $4.68 | $4.68 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.90 Median $7.24 Typical High $13.80 | Facility | None | $4.90 | $7.24 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $4.68 Typical High $8.71 | Professional | None | $4.57 | $4.68 | $8.71 |
CareSource Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
CareSource Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $10.00 Typical High $15.49 | Facility | None | $8.91 | $10.00 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.46 | Professional | None | $4.68 | $4.68 | $6.46 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $8.51 Median $10.00 Typical High $13.49 | Facility | None | $8.51 | $10.00 | $13.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.46 | Professional | None | $4.68 | $4.68 | $6.46 |
Molina Setting Professional Modifier None Typical Low $5.01 Median $5.89 Typical High $6.61 | Professional | None | $5.01 | $5.89 | $6.61 |
SummaCare Setting Professional Modifier None Typical Low $4.90 Median $5.13 Typical High $9.33 | Professional | None | $4.90 | $5.13 | $9.33 |
United Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $6.61 | Professional | None | $4.47 | $4.47 | $6.61 |
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 $2.34 Median $2.34 Typical High $3.02 | Professional | 52 · Reduced service | $2.34 | $2.34 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $0.93 Typical High $1.20 | Professional | 53 · Discontinued | $0.93 | $0.93 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.71 Typical High $0.89 | Professional | 55 · Aftercare only | $0.71 | $0.71 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.47 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.47 | $0.47 | $0.60 |
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· 6th of 51
$5.62
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.