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 $10.72 Median $10.72 Typical High $43.65 | Facility | None | $10.72 | $10.72 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $22.39 | Professional | None | $10.72 | $10.72 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $6.92 Typical High $16.98 | Professional | None | $5.01 | $6.92 | $16.98 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
CareSource Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $22.91 | Professional | None | $21.88 | $21.88 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Molina Setting Professional Modifier None Typical Low $3.98 Median $5.50 Typical High $10.72 | Professional | None | $3.98 | $5.50 | $10.72 |
SummaCare Setting Professional Modifier None Typical Low $14.45 Median $18.20 Typical High $23.44 | Professional | None | $14.45 | $18.20 | $23.44 |
United Setting Professional Modifier None Typical Low $5.62 Median $8.32 Typical High $10.72 | Professional | None | $5.62 | $8.32 | $10.72 |
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 $5.37 Median $5.37 Typical High $11.22 | Professional | 52 · Reduced service | $5.37 | $5.37 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $4.47 | Professional | 53 · Discontinued | $2.14 | $2.14 | $4.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.94 Median $7.94 Typical High $16.60 | Professional | 54 · Surgery only | $7.94 | $7.94 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $3.31 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $2.24 |
Where Ohio sits
The same service costs 2.8 times more in Hawaii 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
$7.08
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.