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 $0.34 Median $0.34 Typical High $7.94 | Facility | None | $0.34 | $0.34 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.36 | Professional | None | $0.34 | $0.34 | $0.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.38 Median $0.81 Typical High $2.29 | Facility | None | $0.38 | $0.81 | $2.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.36 Median $0.42 Typical High $0.58 | Professional | None | $0.36 | $0.42 | $0.58 |
CareSource Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | None | $0.33 | $0.33 | $0.33 |
Cigna Setting Facility Modifier None Typical Low $0.78 Median $0.78 Typical High $1.05 | Facility | None | $0.78 | $0.78 | $1.05 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $0.78 Median $0.78 Typical High $1.05 | Facility | None | $0.78 | $0.78 | $1.05 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.46 | Professional | None | $0.39 | $0.39 | $0.46 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.35 Typical High $0.37 | Professional | None | $0.32 | $0.35 | $0.37 |
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 $0.17 Median $0.17 Typical High $0.18 | Professional | 52 · Reduced service | $0.17 | $0.17 | $0.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.04 |
Where Ohio sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 22nd of 51
$0.36
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.