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 $7.41 Median $20.42 Typical High $41.69 | Facility | None | $7.41 | $20.42 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $25.12 | Professional | None | $7.41 | $7.41 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $4.79 Typical High $12.02 | Professional | None | $3.47 | $4.79 | $12.02 |
Aultcare Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
CareSource Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
CareSource Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | None | $15.14 | $15.14 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Molina Setting Professional Modifier None Typical Low $2.75 Median $3.80 Typical High $7.41 | Professional | None | $2.75 | $3.80 | $7.41 |
SummaCare Setting Professional Modifier None Typical Low $10.23 Median $12.59 Typical High $16.22 | Professional | None | $10.23 | $12.59 | $16.22 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.75 Typical High $7.41 | Professional | None | $3.89 | $5.75 | $7.41 |
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 $3.72 Median $3.72 Typical High $8.51 | Professional | 52 · Reduced service | $3.72 | $3.72 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.48 Median $1.48 Typical High $3.39 | Professional | 53 · Discontinued | $1.48 | $1.48 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.62 Median $5.62 Typical High $12.88 | Professional | 54 · Surgery only | $5.62 | $5.62 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.12 Typical High $2.57 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.74 Median $0.74 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.74 | $0.74 | $1.70 |
Where Ohio sits
The same service costs 2.9 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
$4.90
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.