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 $4.27 Median $4.27 Typical High $18.20 | Facility | None | $4.27 | $4.27 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $6.61 | Professional | None | $4.27 | $4.27 | $6.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.40 Median $3.98 Typical High $9.33 | Professional | None | $2.40 | $3.98 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.51 Median $2.82 Typical High $3.63 | Professional | UE · Used equipment | $2.51 | $2.82 | $3.63 |
CareSource Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
CareSource Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $10.00 | Professional | None | $9.77 | $9.77 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Molina Setting Professional Modifier None Typical Low $2.00 Median $2.75 Typical High $4.17 | Professional | None | $2.00 | $2.75 | $4.17 |
SummaCare Setting Professional Modifier None Typical Low $5.75 Median $6.76 Typical High $9.33 | Professional | None | $5.75 | $6.76 | $9.33 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.31 Typical High $4.27 | Professional | None | $2.19 | $3.31 | $4.27 |
4 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 $0.63 Median $0.63 Typical High $1.45 | Professional | 55 · Aftercare only | $0.63 | $0.63 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.95 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | KX · Policy requirements met | $5.37 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.33 Median $0.33 Typical High $0.44 | Professional | RR · Rental | $0.33 | $0.33 | $0.44 |
Where Ohio sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 41st of 51
$3.80
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.