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 $0.79 Median $1.45 Typical High $3.02 | Facility | None | $0.79 | $1.45 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.85 | Professional | None | $0.79 | $0.79 | $0.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.85 Median $1.86 Typical High $5.25 | Facility | None | $0.85 | $1.86 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.12 | Professional | None | $0.79 | $0.79 | $1.12 |
CareSource Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Facility | None | $0.79 | $0.79 | $0.79 |
CareSource Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.07 | Professional | None | $0.79 | $0.79 | $1.07 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $1.74 Typical High $2.63 | Facility | None | $1.51 | $1.74 | $2.63 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.02 | Professional | None | $0.79 | $0.79 | $1.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.48 Median $1.74 Typical High $2.29 | Facility | None | $1.48 | $1.74 | $2.29 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.10 | Professional | None | $0.79 | $0.79 | $1.10 |
Molina Setting Professional Modifier None Typical Low $0.76 Median $0.79 Typical High $1.20 | Professional | None | $0.76 | $0.79 | $1.20 |
SummaCare Setting Professional Modifier None Typical Low $0.79 Median $0.83 Typical High $0.98 | Professional | None | $0.79 | $0.83 | $0.98 |
United Setting Professional Modifier None Typical Low $0.72 Median $0.79 Typical High $0.89 | Professional | None | $0.72 | $0.79 | $0.89 |
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 $0.40 Median $0.40 Typical High $0.41 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | JZ · No drug discarded | $1.12 | $1.12 | $1.12 |
Where Ohio sits
Rates are fairly even across states for this service. 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· 22nd of 51
$0.79
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.