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 $1.10 Median $1.91 Typical High $2.00 | Facility | None | $1.10 | $1.91 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $5.89 | Professional | None | $1.10 | $1.10 | $5.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.20 Median $2.57 Typical High $7.08 | Facility | None | $1.20 | $2.57 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $2.29 | Professional | None | $1.10 | $1.10 | $2.29 |
CareSource Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Facility | None | $1.35 | $1.35 | $1.35 |
CareSource Setting Professional Modifier None Typical Low $1.23 Median $1.35 Typical High $1.82 | Professional | None | $1.23 | $1.35 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $2.04 Median $2.34 Typical High $3.63 | Facility | None | $2.04 | $2.34 | $3.63 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $4.07 | Professional | None | $1.10 | $1.10 | $4.07 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.04 Median $2.34 Typical High $3.16 | Facility | None | $2.04 | $2.34 | $3.16 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $4.37 | Professional | None | $1.10 | $1.10 | $4.37 |
Molina Setting Professional Modifier None Typical Low $1.10 Median $1.20 Typical High $1.48 | Professional | None | $1.10 | $1.20 | $1.48 |
SummaCare Setting Professional Modifier None Typical Low $1.10 Median $1.15 Typical High $2.09 | Professional | None | $1.10 | $1.15 | $2.09 |
United Setting Professional Modifier None Typical Low $0.44 Median $1.10 Typical High $1.62 | Professional | None | $0.44 | $1.10 | $1.62 |
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 $0.55 Median $0.55 Typical High $8.51 | Professional | 52 · Reduced service | $0.55 | $0.55 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $3.39 | Professional | 53 · Discontinued | $0.22 | $0.22 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $2.51 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $1.70 |
Where Ohio sits
The same service costs 4.3 times more in Wyoming than in Delaware. 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· 32nd of 51
$1.10
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.