How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $13.18 Median $13.18 Typical High $45.71 | Facility | None | $13.18 | $13.18 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $36.31 | Professional | None | $13.18 | $13.18 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.94 Median $10.23 Typical High $29.51 | Professional | None | $7.94 | $10.23 | $29.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.08 Median $9.12 Typical High $9.33 | Professional | UE · Used equipment | $7.08 | $9.12 | $9.33 |
CareSource Setting Facility Modifier None Typical Low $10.23 Median $15.49 Typical High $20.89 | Facility | None | $10.23 | $15.49 | $20.89 |
CareSource Setting Professional Modifier None Typical Low $13.49 Median $18.62 Typical High $28.18 | Professional | None | $13.49 | $18.62 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $12.30 Typical High $12.30 | Facility | None | $8.91 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $8.91 Median $12.30 Typical High $12.30 | Facility | None | $8.91 | $12.30 | $12.30 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
Molina Setting Professional Modifier None Typical Low $5.37 Median $7.41 Typical High $10.00 | Professional | None | $5.37 | $7.41 | $10.00 |
SummaCare Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $33.11 | Professional | None | $20.89 | $21.38 | $33.11 |
United Setting Professional Modifier None Typical Low $6.03 Median $10.00 Typical High $15.14 | Professional | None | $6.03 | $10.00 | $15.14 |
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 $1.95 Median $1.95 Typical High $5.37 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $3.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.93 Median $0.93 Typical High $1.02 | Professional | RR · Rental | $0.93 | $0.93 | $1.02 |
Where Ohio sits
The same service costs 3.0 times more in Hawaii 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· 45th of 51
$10.47
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.