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 $5.75 Median $6.46 Typical High $30.20 | Facility | None | $5.75 | $6.46 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $6.31 | Professional | None | $5.75 | $5.75 | $6.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.89 Median $10.00 Typical High $17.78 | Facility | None | $5.89 | $10.00 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $7.94 | Professional | None | $5.75 | $5.75 | $7.94 |
CareSource Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
CareSource Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $7.76 | Professional | None | $5.75 | $5.75 | $7.76 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $11.75 Typical High $15.85 | Facility | None | $5.75 | $11.75 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.75 Median $11.75 Typical High $16.22 | Facility | None | $5.75 | $11.75 | $16.22 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Molina Setting Professional Modifier None Typical Low $5.75 Median $6.31 Typical High $7.41 | Professional | None | $5.75 | $6.31 | $7.41 |
SummaCare Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
United Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
United Setting Professional Modifier None Typical Low $5.25 Median $5.89 Typical High $6.46 | Professional | None | $5.25 | $5.89 | $6.46 |
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 $2.88 Median $2.88 Typical High $3.16 | Professional | 52 · Reduced service | $2.88 | $2.88 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.15 Typical High $1.26 | Professional | 53 · Discontinued | $1.15 | $1.15 | $1.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.85 Typical High $0.95 | Professional | 55 · Aftercare only | $0.85 | $0.85 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.63 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.63 |
Where Ohio sits
The same service costs 1.5 times more in Alaska than in Pennsylvania. 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· 28th of 51
$5.75
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.