How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.54 Median $0.54 Typical High $0.54 | Facility | None | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.58 | Professional | None | $0.54 | $0.54 | $0.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $4.57 | Professional | 53 · Discontinued | $0.11 | $0.11 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $3.47 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $2.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.10 Median $0.12 Typical High $0.20 | Professional | None | $0.10 | $0.12 | $0.20 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.47 | Professional | None | $0.38 | $0.38 | $0.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | None | $0.34 | $0.34 | $0.34 |
Molina Setting Professional Modifier None Typical Low $0.12 Median $0.14 Typical High $0.22 | Professional | None | $0.12 | $0.14 | $0.22 |
United Setting Professional Modifier None Typical Low $0.05 Median $0.12 Typical High $0.18 | Professional | None | $0.05 | $0.12 | $0.18 |
1 more rate 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 $0.27 Median $0.27 Typical High $0.28 | Professional | 52 · Reduced service | $0.27 | $0.27 | $0.28 |
Where Ohio sits
The same service costs 8.3 times more in Alaska than in Louisiana. 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· 42nd of 51
$0.12
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.