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 $9.12 Median $27.54 Typical High $63.10 | Facility | None | $9.12 | $27.54 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.91 | Professional | None | $8.13 | $8.13 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.91 Median $15.14 Typical High $26.30 | Facility | None | $8.91 | $15.14 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | None | $8.13 | $8.13 | $11.75 |
CareSource Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
CareSource Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $14.45 | Professional | None | $10.72 | $10.72 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $17.78 Typical High $26.92 | Facility | None | $7.41 | $17.78 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $11.48 | Professional | None | $8.13 | $8.13 | $11.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7.41 Median $17.78 Typical High $23.44 | Facility | None | $7.41 | $17.78 | $23.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $11.48 | Professional | None | $8.13 | $8.13 | $11.48 |
Molina Setting Professional Modifier None Typical Low $7.41 Median $8.91 Typical High $10.96 | Professional | None | $7.41 | $8.91 | $10.96 |
SummaCare Setting Professional Modifier None Typical Low $8.13 Median $8.51 Typical High $10.00 | Professional | None | $8.13 | $8.51 | $10.00 |
United Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $7.94 Median $9.12 Typical High $9.77 | Professional | None | $7.94 | $9.12 | $9.77 |
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 $4.07 Median $4.07 Typical High $4.90 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.95 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.48 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.98 |
Where Ohio sits
The same service costs 1.9 times more in Wyoming than in Georgia. 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· 46th of 51
$8.13
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.