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 $9.55 Median $26.92 Typical High $32.36 | Facility | None | $9.55 | $26.92 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $23.99 | Professional | None | $9.55 | $9.55 | $23.99 |
Ambetter Setting Professional Modifier None Typical Low $7.59 Median $7.76 Typical High $9.33 | Professional | None | $7.59 | $7.76 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.47 Median $6.31 Typical High $15.49 | Professional | None | $4.47 | $6.31 | $15.49 |
Aultcare Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
CareSource Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $19.95 | Facility | None | $11.48 | $11.48 | $19.95 |
CareSource Setting Professional Modifier None Typical Low $15.14 Median $20.42 Typical High $21.38 | Professional | None | $15.14 | $20.42 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $9.33 | Professional | None | $6.31 | $6.31 | $9.33 |
Molina Setting Professional Modifier None Typical Low $3.63 Median $5.01 Typical High $9.77 | Professional | None | $3.63 | $5.01 | $9.77 |
SummaCare Setting Professional Modifier None Typical Low $13.18 Median $16.22 Typical High $21.38 | Professional | None | $13.18 | $16.22 | $21.38 |
United Setting Professional Modifier None Typical Low $5.01 Median $7.59 Typical High $9.33 | Professional | None | $5.01 | $7.59 | $9.33 |
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 $4.79 Median $4.79 Typical High $7.08 | Professional | 52 · Reduced service | $4.79 | $4.79 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $1.95 Typical High $2.88 | Professional | 53 · Discontinued | $1.95 | $1.95 | $2.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.24 Median $7.24 Typical High $10.72 | Professional | 54 · Surgery only | $7.24 | $7.24 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $2.14 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $0.98 Typical High $1.45 | Professional | 56 · Pre-op care only | $0.98 | $0.98 | $1.45 |
Where Ohio sits
The same service costs 4.5 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
$6.31
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.