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 $5.13 Median $14.13 Typical High $36.31 | Facility | None | $5.13 | $14.13 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $16.98 | Professional | None | $5.13 | $5.13 | $16.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.40 Median $3.39 Typical High $8.32 | Professional | None | $2.40 | $3.39 | $8.32 |
CareSource Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
CareSource Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | None | $10.47 | $10.47 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Molina Setting Professional Modifier None Typical Low $1.95 Median $2.63 Typical High $5.13 | Professional | None | $1.95 | $2.63 | $5.13 |
SummaCare Setting Professional Modifier None Typical Low $7.08 Median $8.71 Typical High $11.22 | Professional | None | $7.08 | $8.71 | $11.22 |
United Setting Professional Modifier None Typical Low $2.69 Median $3.98 Typical High $5.13 | Professional | None | $2.69 | $3.98 | $5.13 |
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 $2.57 Median $2.57 Typical High $14.45 | Professional | 52 · Reduced service | $2.57 | $2.57 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.02 Typical High $5.75 | Professional | 53 · Discontinued | $1.02 | $1.02 | $5.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.89 Median $3.89 Typical High $21.88 | Professional | 54 · Surgery only | $3.89 | $3.89 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $4.37 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $2.88 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $2.88 |
Where Ohio sits
The same service costs 3.2 times more in Rhode Island than in New York. 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· 50th of 51
$3.39
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.