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 $7.94 Median $7.94 Typical High $28.18 | Facility | None | $7.94 | $7.94 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $21.88 | Professional | None | $7.94 | $7.94 | $21.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $5.75 Typical High $17.78 | Professional | None | $4.57 | $5.75 | $17.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.98 Median $4.37 Typical High $5.75 | Professional | UE · Used equipment | $3.98 | $4.37 | $5.75 |
CareSource Setting Facility Modifier None Typical Low $6.17 Median $9.33 Typical High $12.59 | Facility | None | $6.17 | $9.33 | $12.59 |
CareSource Setting Professional Modifier None Typical Low $8.13 Median $11.22 Typical High $16.98 | Professional | None | $8.13 | $11.22 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $6.17 | Facility | None | $5.89 | $5.89 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | None | $5.01 | $5.13 | $5.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $6.17 | Facility | None | $5.89 | $5.89 | $6.17 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | None | $5.01 | $5.13 | $5.13 |
Molina Setting Professional Modifier None Typical Low $2.14 Median $2.95 Typical High $3.98 | Professional | None | $2.14 | $2.95 | $3.98 |
SummaCare Setting Professional Modifier None Typical Low $12.59 Median $12.88 Typical High $19.95 | Professional | None | $12.59 | $12.88 | $19.95 |
United Setting Professional Modifier None Typical Low $3.63 Median $6.03 Typical High $9.12 | Professional | None | $3.63 | $6.03 | $9.12 |
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 $1.20 Median $1.20 Typical High $3.31 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $2.19 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $2.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.54 Median $0.54 Typical High $0.58 | Professional | RR · Rental | $0.54 | $0.54 | $0.58 |
Where Ohio sits
The same service costs 2.7 times more in Hawaii than in Vermont. 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
$5.37
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.