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 $0.34 Median $0.44 Typical High $1.00 | Facility | None | $0.34 | $0.44 | $1.00 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.34 Typical High $0.46 | Professional | None | $0.32 | $0.34 | $0.46 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.28 Median $0.71 Typical High $0.95 | Professional | None | $0.28 | $0.71 | $0.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.17 Median $0.21 Typical High $0.30 | Professional | UE · Used equipment | $0.17 | $0.21 | $0.30 |
CareSource Setting Facility Modifier None Typical Low $0.59 Median $0.59 Typical High $0.69 | Facility | None | $0.59 | $0.59 | $0.69 |
CareSource Setting Professional Modifier None Typical Low $0.52 Median $0.60 Typical High $0.79 | Professional | None | $0.52 | $0.60 | $0.79 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.35 Median $3.09 Typical High $9.55 | Facility | None | $1.35 | $3.09 | $9.55 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Molina Setting Professional Modifier None Typical Low $0.30 Median $0.42 Typical High $0.63 | Professional | None | $0.30 | $0.42 | $0.63 |
SummaCare Setting Professional Modifier None Typical Low $0.46 Median $0.54 Typical High $0.74 | Professional | None | $0.46 | $0.54 | $0.74 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.26 Typical High $0.36 | Professional | None | $0.17 | $0.26 | $0.36 |
6 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 Facility Modifier RR · Rental Typical Low $0.03 Median $0.03 Typical High $0.05 | Facility | RR · Rental | $0.03 | $0.03 | $0.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.17 Median $0.17 Typical High $0.24 | Professional | 52 · Reduced service | $0.17 | $0.17 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.10 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.08 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.05 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.03 Typical High $0.05 | Professional | RR · Rental | $0.03 | $0.03 | $0.05 |
Where Ohio sits
The same service costs 4.6 times more in Hawaii 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· 34th of 51
$0.31
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.