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 $1.95 Median $1.95 Typical High $8.91 | Facility | None | $1.95 | $1.95 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $7.08 | Professional | None | $1.95 | $1.95 | $7.08 |
Ambetter Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $4.27 | Professional | None | $1.38 | $1.38 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.05 Median $1.38 Typical High $1.62 | Professional | UE · Used equipment | $1.05 | $1.38 | $1.62 |
Aultcare Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
CareSource Setting Facility Modifier None Typical Low $1.55 Median $2.34 Typical High $3.09 | Facility | None | $1.55 | $2.34 | $3.09 |
CareSource Setting Professional Modifier None Typical Low $2.04 Median $2.82 Typical High $4.17 | Professional | None | $2.04 | $2.82 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.29 | Facility | None | $1.86 | $1.86 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.86 | Professional | None | $1.58 | $1.58 | $1.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.29 | Facility | None | $1.86 | $1.86 | $2.29 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.91 | Professional | None | $1.58 | $1.58 | $1.91 |
Molina Setting Professional Modifier None Typical Low $1.58 Median $2.19 Typical High $2.95 | Professional | None | $1.58 | $2.19 | $2.95 |
SummaCare Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $5.01 | Professional | None | $3.16 | $3.16 | $5.01 |
United Setting Professional Modifier None Typical Low $0.89 Median $1.48 Typical High $2.24 | Professional | None | $0.89 | $1.48 | $2.24 |
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 $0.30 Median $0.30 Typical High $1.05 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.14 Median $0.14 Typical High $0.15 | Professional | RR · Rental | $0.14 | $0.14 | $0.15 |
Where Ohio sits
The same service costs 3.0 times more in Hawaii than in New Hampshire. 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
$1.58
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.