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 $5.37 Median $5.37 Typical High $28.84 | Facility | None | $5.37 | $5.37 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $10.00 | Professional | None | $5.37 | $5.37 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $4.57 Typical High $12.02 | Professional | None | $2.63 | $4.57 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.75 Median $3.09 Typical High $3.89 | Professional | UE · Used equipment | $2.75 | $3.09 | $3.89 |
CareSource Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
CareSource Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | None | $12.88 | $12.88 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $6.31 Typical High $9.55 | Professional | None | $4.68 | $6.31 | $9.55 |
SummaCare Setting Professional Modifier None Typical Low $7.41 Median $8.71 Typical High $12.02 | Professional | None | $7.41 | $8.71 | $12.02 |
United Setting Professional Modifier None Typical Low $2.82 Median $4.27 Typical High $5.75 | Professional | None | $2.82 | $4.27 | $5.75 |
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 $0.81 Median $0.81 Typical High $1.51 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.54 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.54 | $0.54 | $1.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.42 Median $0.42 Typical High $0.71 | Professional | RR · Rental | $0.42 | $0.42 | $0.71 |
Where Ohio sits
The same service costs 2.7 times more in Hawaii 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· 34th of 51
$5.13
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.