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 $0.20 Median $0.20 Typical High $0.22 | Facility | None | $0.20 | $0.20 | $0.22 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.22 Median $0.47 Typical High $1.29 | Facility | None | $0.22 | $0.47 | $1.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.42 | Professional | None | $0.20 | $0.20 | $0.42 |
CareSource Setting Facility Modifier None Typical Low $0.19 Median $0.19 Typical High $0.19 | Facility | None | $0.19 | $0.19 | $0.19 |
CareSource Setting Professional Modifier None Typical Low $0.17 Median $0.19 Typical High $0.26 | Professional | None | $0.17 | $0.19 | $0.26 |
Cigna Setting Facility Modifier None Typical Low $0.38 Median $0.43 Typical High $0.68 | Facility | None | $0.38 | $0.43 | $0.68 |
Cigna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.32 | Professional | None | $0.20 | $0.20 | $0.32 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $0.36 Median $0.43 Typical High $0.56 | Facility | None | $0.36 | $0.43 | $0.56 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.32 | Professional | None | $0.20 | $0.20 | $0.32 |
Molina Setting Professional Modifier None Typical Low $0.20 Median $0.22 Typical High $0.28 | Professional | None | $0.20 | $0.22 | $0.28 |
SummaCare Setting Professional Modifier None Typical Low $0.20 Median $0.21 Typical High $0.38 | Professional | None | $0.20 | $0.21 | $0.38 |
United Setting Professional Modifier None Typical Low $0.08 Median $0.20 Typical High $0.28 | Professional | None | $0.08 | $0.20 | $0.28 |
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 $0.10 Median $0.10 Typical High $0.10 | Professional | 52 · Reduced service | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 53 · Discontinued | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $7.76 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $7.76 |
Where Ohio sits
The same service costs 1.6 times more in Wyoming than in Rhode Island. 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· 14th of 51
$0.20
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.