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 $3.02 Median $3.02 Typical High $30.20 | Facility | None | $3.02 | $3.02 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $30.20 | Professional | None | $3.02 | $3.02 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.31 Median $5.75 Typical High $10.00 | Facility | None | $3.31 | $5.75 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.09 Typical High $6.46 | Professional | None | $3.02 | $3.09 | $6.46 |
CareSource Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
CareSource Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $6.61 Typical High $10.00 | Facility | None | $5.75 | $6.61 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $21.88 | Professional | None | $3.02 | $3.02 | $21.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.17 Median $6.61 Typical High $8.71 | Facility | None | $6.17 | $6.61 | $8.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $21.88 | Professional | None | $3.02 | $3.02 | $21.88 |
SummaCare Setting Professional Modifier None Typical Low $3.02 Median $3.31 Typical High $6.03 | Professional | None | $3.02 | $3.31 | $6.03 |
United Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.79 | Professional | None | $3.24 | $3.24 | $4.79 |
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 $1.51 Median $1.51 Typical High $15.14 | Professional | 52 · Reduced service | $1.51 | $1.51 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $6.03 | Professional | 53 · Discontinued | $0.62 | $0.62 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $4.47 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $3.02 |
Where Ohio sits
The same service costs 6.0 times more in Wyoming than in Georgia. 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· 15th of 51
$3.72
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.