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 $0.02 Median $0.02 Typical High $0.04 | Facility | None | $0.02 | $0.02 | $0.04 |
Aetna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.05 | Professional | None | $0.02 | $0.02 | $0.05 |
Ambetter Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.05 Typical High $0.13 | Facility | None | $0.02 | $0.05 | $0.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Aultcare Setting Facility Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Facility | None | $0.03 | $0.03 | $0.03 |
Aultcare Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
CareSource Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.39 | Professional | None | $0.02 | $0.02 | $0.39 |
Cigna Setting Facility Modifier None Typical Low $0.04 Median $0.04 Typical High $0.07 | Facility | None | $0.04 | $0.04 | $0.07 |
Cigna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $0.02 Median $0.06 Typical High $4.68 | Facility | None | $0.02 | $0.06 | $4.68 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
SummaCare Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
United Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
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 $0.50 Median $1.51 Typical High $7.08 | Professional | 52 · Reduced service | $0.50 | $1.51 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.60 Typical High $2.82 | Professional | 53 · Discontinued | $0.20 | $0.60 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.45 Typical High $2.09 | Professional | 55 · Aftercare only | $0.15 | $0.45 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.30 Typical High $1.41 | Professional | 56 · Pre-op care only | $0.10 | $0.30 | $1.41 |
Where Ohio sits
The same service costs 6.0 times more in Wyoming than in Massachusetts. 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· 26th of 51
$0.02
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.