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 $5.25 Median $14.45 Typical High $21.38 | Facility | None | $5.25 | $14.45 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.50 | Professional | None | $5.25 | $5.25 | $5.50 |
Ambetter Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.37 Median $10.72 Typical High $34.67 | Facility | None | $5.37 | $10.72 | $34.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.41 | Professional | None | $5.25 | $5.25 | $7.41 |
Aultcare Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
CareSource Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
CareSource Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $8.71 | Professional | None | $6.76 | $6.76 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $11.22 Typical High $17.38 | Facility | None | $5.75 | $11.22 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.03 | Professional | None | $5.25 | $5.25 | $6.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.75 Median $11.22 Typical High $16.22 | Facility | None | $5.75 | $11.22 | $16.22 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $19.50 | Professional | None | $5.25 | $5.25 | $19.50 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $5.75 Typical High $7.08 | Professional | None | $4.90 | $5.75 | $7.08 |
SummaCare Setting Professional Modifier None Typical Low $5.25 Median $5.50 Typical High $6.46 | Professional | None | $5.25 | $5.50 | $6.46 |
United Setting Professional Modifier None Typical Low $4.57 Median $4.90 Typical High $5.50 | Professional | None | $4.57 | $4.90 | $5.50 |
5 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 $2.63 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.15 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.87 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.58 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $4.17 Median $6.92 Typical High $6.92 | Professional | JZ · No drug discarded | $4.17 | $6.92 | $6.92 |
Where Ohio sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 20th of 51
$5.25
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.