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 $0.95 Median $0.95 Typical High $0.95 | Facility | None | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $1.00 | Professional | None | $0.95 | $0.95 | $1.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.83 Median $1.05 Typical High $1.62 | Professional | None | $0.83 | $1.05 | $1.62 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.41 | Professional | None | $1.12 | $1.12 | $1.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | None | $0.52 | $0.52 | $0.52 |
Molina Setting Professional Modifier None Typical Low $1.15 Median $1.35 Typical High $2.09 | Professional | None | $1.15 | $1.35 | $2.09 |
United Setting Professional Modifier None Typical Low $0.42 Median $1.05 Typical High $1.55 | Professional | None | $0.42 | $1.05 | $1.55 |
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 $0.48 Median $0.48 Typical High $0.51 | Professional | 52 · Reduced service | $0.48 | $0.48 | $0.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.19 Median $0.19 Typical High $10.96 | Professional | 53 · Discontinued | $0.19 | $0.19 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $8.51 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $5.75 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $5.75 |
Where Ohio sits
The same service costs 10.0 times more in Kansas than in Oklahoma. 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· 20th of 51
$1.05
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.