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 $0.39 Median $0.39 Typical High $3.98 | Facility | None | $0.39 | $0.39 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.63 | Professional | None | $0.39 | $0.39 | $0.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.68 Median $1.02 Typical High $2.00 | Professional | None | $0.68 | $1.02 | $2.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.45 Median $0.52 Typical High $0.78 | Professional | UE · Used equipment | $0.45 | $0.52 | $0.78 |
CareSource Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Molina Setting Professional Modifier None Typical Low $0.62 Median $0.91 Typical High $1.17 | Professional | None | $0.62 | $0.91 | $1.17 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.40 Typical High $0.56 | Professional | None | $0.26 | $0.40 | $0.56 |
3 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 $0.06 Median $0.06 Typical High $0.09 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.06 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.18 Median $0.18 Typical High $0.21 | Professional | RR · Rental | $0.18 | $0.18 | $0.21 |
Where Ohio sits
The same service costs 190.5 times more in Wyoming 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· 26th of 51
$0.72
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.