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 $5.13 Median $5.13 Typical High $147.91 | Facility | None | $5.13 | $5.13 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $93.33 | Professional | None | $5.13 | $5.13 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $7.94 Typical High $11.48 | Professional | None | $5.01 | $7.94 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.25 Median $5.89 Typical High $7.08 | Professional | UE · Used equipment | $5.25 | $5.89 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Molina Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $20.89 | Professional | None | $14.13 | $14.13 | $20.89 |
United Setting Professional Modifier None Typical Low $3.47 Median $5.13 Typical High $8.13 | Professional | None | $3.47 | $5.13 | $8.13 |
2 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 $0.78 Median $0.78 Typical High $14.13 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $9.33 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $9.33 |
Where Ohio sits
The same service costs 3.2 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· 27th of 51
$7.41
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.