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 $3.02 Median $3.02 Typical High $12.88 | Facility | None | $3.02 | $3.02 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $4.27 | Professional | None | $3.02 | $3.02 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.48 Median $2.51 Typical High $7.08 | Professional | None | $1.48 | $2.51 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.51 Median $1.74 Typical High $2.19 | Professional | UE · Used equipment | $1.51 | $1.74 | $2.19 |
CareSource Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
CareSource Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.46 | Professional | None | $6.17 | $6.17 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Molina Setting Professional Modifier None Typical Low $2.69 Median $3.72 Typical High $5.62 | Professional | None | $2.69 | $3.72 | $5.62 |
SummaCare Setting Professional Modifier None Typical Low $4.17 Median $4.90 Typical High $6.61 | Professional | None | $4.17 | $4.90 | $6.61 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.34 Typical High $2.95 | Professional | None | $1.58 | $2.34 | $2.95 |
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 52 · Reduced service Typical Low $1.51 Median $1.51 Typical High $2.14 | Professional | 52 · Reduced service | $1.51 | $1.51 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $0.85 | Professional | 53 · Discontinued | $0.60 | $0.60 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.65 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.18 Median $0.21 Typical High $0.28 | Professional | RR · Rental | $0.18 | $0.21 | $0.28 |
Where Ohio sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 39th of 51
$2.34
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.