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 $16.22 Median $44.67 Typical High $54.95 | Facility | None | $16.22 | $44.67 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $16.22 Typical High $44.67 | Professional | None | $15.85 | $16.22 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.59 Median $10.72 Typical High $26.30 | Professional | None | $7.59 | $10.72 | $26.30 |
Aultcare Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
CareSource Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
CareSource Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $34.67 | Professional | None | $33.11 | $33.11 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $15.85 | Professional | None | $10.72 | $10.72 | $15.85 |
Molina Setting Professional Modifier None Typical Low $6.17 Median $8.32 Typical High $16.60 | Professional | None | $6.17 | $8.32 | $16.60 |
SummaCare Setting Professional Modifier None Typical Low $22.39 Median $27.54 Typical High $36.31 | Professional | None | $22.39 | $27.54 | $36.31 |
United Setting Professional Modifier None Typical Low $8.51 Median $12.59 Typical High $15.85 | Professional | None | $8.51 | $12.59 | $15.85 |
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 $8.13 Median $8.13 Typical High $20.42 | Professional | 52 · Reduced service | $8.13 | $8.13 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $8.13 | Professional | 53 · Discontinued | $3.24 | $3.24 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $12.30 Typical High $30.90 | Professional | 54 · Surgery only | $12.30 | $12.30 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $6.17 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $4.07 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $4.07 |
Where Ohio sits
The same service costs 3.5 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
$10.72
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.