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 $1.95 | Professional | None | $1.17 | $1.17 | $1.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $8.71 Typical High $12.30 | Professional | None | $6.31 | $8.71 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.62 Median $6.61 Typical High $9.77 | Professional | UE · Used equipment | $5.62 | $6.61 | $9.77 |
CareSource Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $0.87 Median $1.70 Typical High $1.70 | Professional | None | $0.87 | $1.70 | $1.70 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.87 Median $1.70 Typical High $1.70 | Professional | None | $0.87 | $1.70 | $1.70 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $16.60 Typical High $20.89 | Professional | None | $10.96 | $16.60 | $20.89 |
United Setting Professional Modifier None Typical Low $0.79 Median $1.20 Typical High $2.00 | Professional | None | $0.79 | $1.20 | $2.00 |
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 $0.56 Median $0.56 Typical High $0.66 | Professional | RR · Rental | $0.56 | $0.56 | $0.66 |
Where Ohio sits
The same service costs 6.6 times more in Kentucky than in West Virginia. 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
$6.31
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.