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 $5.37 Median $14.79 Typical High $28.84 | Facility | None | $5.37 | $14.79 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $13.80 | Professional | None | $5.37 | $5.37 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $3.47 Typical High $8.51 | Professional | None | $2.51 | $3.47 | $8.51 |
CareSource Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
CareSource Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | None | $10.96 | $10.96 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Molina Setting Professional Modifier None Typical Low $2.00 Median $2.75 Typical High $5.37 | Professional | None | $2.00 | $2.75 | $5.37 |
SummaCare Setting Professional Modifier None Typical Low $7.24 Median $9.12 Typical High $11.75 | Professional | None | $7.24 | $9.12 | $11.75 |
United Setting Professional Modifier None Typical Low $2.82 Median $4.17 Typical High $5.37 | Professional | None | $2.82 | $4.17 | $5.37 |
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 $2.69 Median $2.69 Typical High $7.08 | Professional | 52 · Reduced service | $2.69 | $2.69 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $2.82 | Professional | 53 · Discontinued | $1.07 | $1.07 | $2.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.98 Median $3.98 Typical High $10.47 | Professional | 54 · Surgery only | $3.98 | $3.98 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $2.09 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $1.41 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $1.41 |
Where Ohio sits
The same service costs 4.1 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
$3.47
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.