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 $1.17 Median $1.17 Typical High $15.14 | Facility | None | $1.17 | $1.17 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.86 | Professional | None | $1.17 | $1.17 | $1.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $4.47 Typical High $6.61 | Professional | None | $2.88 | $4.47 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.39 Typical High $4.07 | Professional | UE · Used equipment | $3.02 | $3.39 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $60.26 | Professional | None | $30.20 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $0.79 Median $1.20 Typical High $1.70 | Professional | None | $0.79 | $1.20 | $1.70 |
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 $0.18 Median $0.18 Typical High $0.28 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.27 Median $0.27 Typical High $0.32 | Professional | RR · Rental | $0.27 | $0.27 | $0.32 |
Where Ohio sits
The same service costs 6.0 times more in Minnesota 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· 3rd of 51
$3.55
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.