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 $18.62 Median $18.62 Typical High $151.36 | Facility | None | $18.62 | $18.62 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.38 | Professional | None | $18.62 | $18.62 | $21.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.42 Median $32.36 Typical High $57.54 | Facility | None | $20.42 | $32.36 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $26.92 | Professional | None | $18.62 | $18.62 | $26.92 |
Aultcare Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
CareSource Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
CareSource Setting Professional Modifier None Typical Low $21.88 Median $26.30 Typical High $35.48 | Professional | None | $21.88 | $26.30 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $39.81 Typical High $53.70 | Facility | None | $20.89 | $39.81 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | None | $18.62 | $18.62 | $19.50 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $20.89 Median $39.81 Typical High $53.70 | Facility | None | $20.89 | $39.81 | $53.70 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | None | $18.62 | $18.62 | $19.50 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $22.39 Typical High $26.30 | Professional | None | $18.62 | $22.39 | $26.30 |
SummaCare Setting Professional Modifier None Typical Low $18.62 Median $19.50 Typical High $22.91 | Professional | None | $18.62 | $19.50 | $22.91 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $18.62 Median $21.38 Typical High $22.91 | Professional | None | $18.62 | $21.38 | $22.91 |
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 $9.33 Median $9.33 Typical High $9.77 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $4.27 | Professional | 53 · Discontinued | $3.72 | $3.72 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $3.24 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $2.14 |
Where Ohio sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 51st of 51
$18.62
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.