How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $12.88 Median $12.88 Typical High $58.88 | Facility | None | $12.88 | $12.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $58.88 | Professional | None | $12.88 | $12.88 | $58.88 |
Ambetter Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $19.95 | Professional | None | $15.85 | $19.95 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.77 Median $10.72 Typical High $31.62 | Professional | None | $9.77 | $10.72 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $22.39 Median $23.99 Typical High $23.99 | Professional | None | $22.39 | $23.99 | $23.99 |
Molina Setting Professional Modifier None Typical Low $22.39 Median $37.15 Typical High $53.70 | Professional | None | $22.39 | $37.15 | $53.70 |
SummaCare Setting Professional Modifier None Typical Low $23.44 Median $24.55 Typical High $37.15 | Professional | None | $23.44 | $24.55 | $37.15 |
United Setting Professional Modifier None Typical Low $13.18 Median $23.99 Typical High $53.70 | Professional | None | $13.18 | $23.99 | $53.70 |
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 $6.46 Median $6.46 Typical High $29.51 | Professional | 52 · Reduced service | $6.46 | $6.46 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $11.75 | Professional | 53 · Discontinued | $2.63 | $2.63 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $8.91 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $5.89 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $5.89 |
Where Ohio sits
The same service costs 4.1 times more in Wyoming than in Kentucky. 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· 39th of 51
$23.99
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.