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 $0.91 Median $0.91 Typical High $28.18 | Facility | None | $0.91 | $0.91 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $3.89 | Professional | None | $0.91 | $0.91 | $3.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.90 Median $7.59 Typical High $9.55 | Professional | None | $4.90 | $7.59 | $9.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.79 Median $5.75 Typical High $7.94 | Professional | UE · Used equipment | $4.79 | $5.75 | $7.94 |
CareSource Setting Facility Modifier None Typical Low $1.17 Median $1.17 Typical High $1.86 | Facility | None | $1.17 | $1.17 | $1.86 |
CareSource Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.91 | Professional | None | $1.17 | $1.17 | $1.91 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Molina Setting Professional Modifier None Typical Low $0.89 Median $1.23 Typical High $1.86 | Professional | None | $0.89 | $1.23 | $1.86 |
SummaCare Setting Professional Modifier None Typical Low $1.20 Median $1.41 Typical High $1.95 | Professional | None | $1.20 | $1.41 | $1.95 |
United Setting Professional Modifier None Typical Low $0.56 Median $0.85 Typical High $8.71 | Professional | None | $0.56 | $0.85 | $8.71 |
5 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 $0.14 Median $0.14 Typical High $0.51 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.71 |
Ambetter Setting Professional Modifier KS · Glucose supply, no insulin Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | KS · Glucose supply, no insulin | $1.12 | $1.12 | $1.12 |
Anthem BCBS Setting Professional Modifier KL · Delivered by mail Typical Low $9.77 Median $12.88 Typical High $16.98 | Professional | KL · Delivered by mail | $9.77 | $12.88 | $16.98 |
SummaCare Setting Professional Modifier KL · Delivered by mail Typical Low $1.55 Median $1.82 Typical High $2.51 | Professional | KL · Delivered by mail | $1.55 | $1.82 | $2.51 |
Where Ohio sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 4th of 51
$5.50
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.