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 $14.13 Median $14.13 Typical High $52.48 | Facility | None | $14.13 | $14.13 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $52.48 | Professional | None | $14.13 | $14.13 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $28.84 | Professional | None | $10.00 | $10.00 | $28.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.59 Median $7.59 Typical High $11.48 | Professional | UE · Used equipment | $7.59 | $7.59 | $11.48 |
Aultcare Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
CareSource Setting Facility Modifier None Typical Low $11.22 Median $16.60 Typical High $22.39 | Facility | None | $11.22 | $16.60 | $22.39 |
CareSource Setting Professional Modifier None Typical Low $14.45 Median $19.95 Typical High $30.20 | Professional | None | $14.45 | $19.95 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $13.49 | Facility | None | $9.55 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $13.49 | Facility | None | $9.55 | $13.49 | $13.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $11.22 Median $11.48 Typical High $11.48 | Professional | None | $11.22 | $11.48 | $11.48 |
Molina Setting Professional Modifier None Typical Low $7.94 Median $10.96 Typical High $14.79 | Professional | None | $7.94 | $10.96 | $14.79 |
SummaCare Setting Professional Modifier None Typical Low $22.91 Median $23.44 Typical High $36.31 | Professional | None | $22.91 | $23.44 | $36.31 |
United Setting Professional Modifier None Typical Low $6.61 Median $10.72 Typical High $16.22 | Professional | None | $6.61 | $10.72 | $16.22 |
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 $2.14 Median $2.14 Typical High $7.76 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $5.25 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.00 Median $1.00 Typical High $1.10 | Professional | RR · Rental | $1.00 | $1.00 | $1.10 |
Where Ohio sits
The same service costs 2.8 times more in Hawaii than in Connecticut. 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· 48th of 51
$11.22
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.