How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $15.85 Median $15.85 Typical High $69.18 | Facility | None | $15.85 | $15.85 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $25.12 | Professional | None | $15.85 | $15.85 | $25.12 |
Ambetter Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $28.84 | Professional | None | $21.88 | $21.88 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.55 Median $13.49 Typical High $25.12 | Professional | None | $9.55 | $13.49 | $25.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.51 Median $10.00 Typical High $14.13 | Professional | UE · Used equipment | $8.51 | $10.00 | $14.13 |
CareSource Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $33.88 Typical High $35.48 | Professional | None | $25.12 | $33.88 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $22.39 Typical High $33.88 | Professional | None | $16.60 | $22.39 | $33.88 |
SummaCare Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $39.81 | Professional | None | $24.55 | $28.84 | $39.81 |
United Setting Professional Modifier None Typical Low $8.71 Median $13.80 Typical High $19.05 | Professional | None | $8.71 | $13.80 | $19.05 |
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 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $3.72 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $2.51 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | KX · Policy requirements met | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.29 Median $1.38 Typical High $1.74 | Professional | RR · Rental | $1.29 | $1.38 | $1.74 |
Where Ohio sits
The same service costs 2.5 times more in Hawaii than in Colorado. 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· 35th of 51
$15.14
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.