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 $0.43 Median $0.87 Typical High $2.14 | Facility | None | $0.43 | $0.87 | $2.14 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.35 Typical High $2.14 | Professional | None | $0.32 | $0.35 | $2.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.30 Median $0.49 Typical High $0.93 | Facility | None | $0.30 | $0.49 | $0.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.68 | Professional | None | $0.32 | $0.32 | $0.68 |
CareSource Setting Facility Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Facility | None | $0.30 | $0.30 | $0.30 |
CareSource Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | None | $0.41 | $0.41 | $0.41 |
Cigna Setting Facility Modifier None Typical Low $0.28 Median $0.69 Typical High $0.91 | Facility | None | $0.28 | $0.69 | $0.91 |
Cigna Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.87 | Professional | None | $0.32 | $0.32 | $0.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $0.28 Median $0.69 Typical High $0.91 | Facility | None | $0.28 | $0.69 | $0.91 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.87 | Professional | None | $0.32 | $0.32 | $0.87 |
Molina Setting Professional Modifier None Typical Low $0.31 Median $0.39 Typical High $0.45 | Professional | None | $0.31 | $0.39 | $0.45 |
SummaCare Setting Professional Modifier None Typical Low $0.34 Median $0.35 Typical High $0.65 | Professional | None | $0.34 | $0.35 | $0.65 |
United Setting Facility Modifier None Typical Low $0.32 Median $0.32 Typical High $0.32 | Facility | None | $0.32 | $0.32 | $0.32 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.31 Typical High $0.60 | Professional | None | $0.28 | $0.31 | $0.60 |
4 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 $0.16 Median $0.16 Typical High $0.50 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.20 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.15 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.10 |
Where Ohio sits
The same service costs 2.8 times more in Texas than in Rhode Island. 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· 8th of 51
$0.38
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.