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 $0.44 Median $0.52 Typical High $3.02 | Facility | None | $0.44 | $0.52 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $3.02 | Professional | None | $0.44 | $0.44 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.48 Median $1.02 Typical High $2.88 | Facility | None | $0.48 | $1.02 | $2.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.81 | Professional | None | $0.44 | $0.44 | $0.81 |
CareSource Setting Facility Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Facility | None | $0.39 | $0.39 | $0.39 |
CareSource Setting Professional Modifier None Typical Low $0.35 Median $0.39 Typical High $0.52 | Professional | None | $0.35 | $0.39 | $0.52 |
Cigna Setting Facility Modifier None Typical Low $0.83 Median $0.95 Typical High $1.48 | Facility | None | $0.83 | $0.95 | $1.48 |
Cigna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.54 | Professional | None | $0.44 | $0.44 | $0.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $0.83 Median $0.95 Typical High $1.26 | Facility | None | $0.83 | $0.95 | $1.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.54 | Professional | None | $0.44 | $0.44 | $0.54 |
Molina Setting Professional Modifier None Typical Low $0.40 Median $0.44 Typical High $0.56 | Professional | None | $0.40 | $0.44 | $0.56 |
SummaCare Setting Professional Modifier None Typical Low $0.44 Median $0.46 Typical High $0.85 | Professional | None | $0.44 | $0.46 | $0.85 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.44 Typical High $0.65 | Professional | None | $0.18 | $0.44 | $0.65 |
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 $0.22 Median $0.22 Typical High $1.51 | Professional | 52 · Reduced service | $0.22 | $0.22 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.60 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.45 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.30 |
Where Ohio sits
The same service costs 1.6 times more in Alaska than in Montana. 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· 27th of 51
$0.44
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.