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 $2.57 Median $3.89 Typical High $4.68 | Facility | None | $2.57 | $3.89 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.98 | Professional | None | $2.57 | $2.57 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.63 Median $3.98 Typical High $7.41 | Facility | None | $2.63 | $3.98 | $7.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $2.57 Typical High $4.27 | Professional | None | $2.51 | $2.57 | $4.27 |
CareSource Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
CareSource Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $4.90 Median $5.50 Typical High $8.51 | Facility | None | $4.90 | $5.50 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.39 | Professional | None | $2.57 | $2.57 | $3.39 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4.68 Median $5.50 Typical High $7.41 | Facility | None | $4.68 | $5.50 | $7.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.39 | Professional | None | $2.57 | $2.57 | $3.39 |
Molina Setting Professional Modifier None Typical Low $2.69 Median $3.24 Typical High $3.63 | Professional | None | $2.69 | $3.24 | $3.63 |
SummaCare Setting Professional Modifier None Typical Low $2.69 Median $2.82 Typical High $5.13 | Professional | None | $2.69 | $2.82 | $5.13 |
United Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.63 | Professional | None | $2.45 | $2.45 | $3.63 |
5 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 $1.29 Median $1.29 Typical High $2.00 | Professional | 52 · Reduced service | $1.29 | $1.29 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $0.79 | Professional | 53 · Discontinued | $0.52 | $0.52 | $0.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $1.95 Typical High $3.02 | Professional | 54 · Surgery only | $1.95 | $1.95 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.39 Typical High $0.60 | Professional | 55 · Aftercare only | $0.39 | $0.39 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.40 |
Where Ohio sits
The same service costs 1.8 times more in Alaska than in Maryland. 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
$3.09
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.