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 $8.71 Median $8.71 Typical High $64.57 | Facility | None | $8.71 | $8.71 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $9.33 | Professional | None | $8.71 | $8.71 | $9.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.00 Median $21.38 Typical High $58.88 | Facility | None | $10.00 | $21.38 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $12.02 Typical High $16.60 | Professional | None | $11.48 | $12.02 | $16.60 |
CareSource Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $19.95 Typical High $26.92 | Facility | None | $9.33 | $19.95 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $9.33 Median $19.95 Typical High $26.92 | Facility | None | $9.33 | $19.95 | $26.92 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Molina Setting Professional Modifier None Typical Low $12.02 Median $13.18 Typical High $15.49 | Professional | None | $12.02 | $13.18 | $15.49 |
SummaCare Setting Professional Modifier None Typical Low $9.77 Median $10.23 Typical High $12.02 | Professional | None | $9.77 | $10.23 | $12.02 |
United Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $9.55 | Professional | None | $8.32 | $9.12 | $9.55 |
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 $4.37 Median $4.37 Typical High $4.68 | Professional | 52 · Reduced service | $4.37 | $4.37 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $1.78 Typical High $1.86 | Professional | 53 · Discontinued | $1.78 | $1.78 | $1.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.32 Median $1.32 Typical High $1.41 | Professional | 55 · Aftercare only | $1.32 | $1.32 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $0.93 |
Where Ohio sits
The same service costs 1.8 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· 24th of 51
$9.33
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.