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 $3.39 Median $3.39 Typical High $37.15 | Facility | None | $3.39 | $3.39 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $5.62 | Professional | None | $3.39 | $3.39 | $5.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.62 Median $2.24 Typical High $5.50 | Professional | None | $1.62 | $2.24 | $5.50 |
CareSource Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
CareSource Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.24 | Professional | None | $7.08 | $7.08 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Molina Setting Professional Modifier None Typical Low $1.29 Median $1.78 Typical High $3.47 | Professional | None | $1.29 | $1.78 | $3.47 |
SummaCare Setting Professional Modifier None Typical Low $4.68 Median $5.75 Typical High $7.59 | Professional | None | $4.68 | $5.75 | $7.59 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.63 Typical High $3.39 | Professional | None | $1.78 | $2.63 | $3.39 |
6 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 $1.70 Median $1.70 Typical High $3.55 | Professional | 52 · Reduced service | $1.70 | $1.70 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $1.41 | Professional | 53 · Discontinued | $0.68 | $0.68 | $1.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.57 Median $2.57 Typical High $5.37 | Professional | 54 · Surgery only | $2.57 | $2.57 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.51 Median $0.51 Typical High $1.07 | Professional | 55 · Aftercare only | $0.51 | $0.51 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $1.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.88 Median $2.88 Typical High $3.72 | Professional | UE · Used equipment | $2.88 | $2.88 | $3.72 |
Where Ohio sits
The same service costs 3.8 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
$2.24
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.