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 $6.46 Median $6.46 Typical High $30.20 | Facility | None | $6.46 | $6.46 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $16.98 | Professional | None | $6.46 | $6.46 | $16.98 |
Ambetter Setting Professional Modifier None Typical Low $7.08 Median $7.76 Typical High $8.32 | Professional | None | $7.08 | $7.76 | $8.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $13.18 | Professional | None | $5.13 | $5.13 | $13.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.63 Median $3.89 Typical High $5.50 | Professional | UE · Used equipment | $3.63 | $3.89 | $5.50 |
Aultcare Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
CareSource Setting Facility Modifier None Typical Low $5.13 Median $7.76 Typical High $10.23 | Facility | None | $5.13 | $7.76 | $10.23 |
CareSource Setting Professional Modifier None Typical Low $9.33 Median $13.80 Typical High $16.60 | Professional | None | $9.33 | $13.80 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.61 | Facility | None | $6.17 | $6.17 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.17 | Professional | None | $5.25 | $5.25 | $6.17 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.61 | Facility | None | $6.17 | $6.17 | $6.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.17 | Professional | None | $5.25 | $5.25 | $6.17 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $7.59 Typical High $10.23 | Professional | None | $5.62 | $7.59 | $10.23 |
SummaCare Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $16.60 | Professional | None | $10.47 | $10.47 | $16.60 |
United Setting Professional Modifier None Typical Low $3.39 Median $4.90 Typical High $7.41 | Professional | None | $3.39 | $4.90 | $7.41 |
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 $0.98 Median $0.98 Typical High $2.51 | Professional | 55 · Aftercare only | $0.98 | $0.98 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.65 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.65 | $0.65 | $1.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.48 Median $0.48 Typical High $0.52 | Professional | RR · Rental | $0.48 | $0.48 | $0.52 |
Where Ohio sits
The same service costs 2.1 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· 47th of 51
$5.25
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.