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 $1.38 Median $1.38 Typical High $5.01 | Facility | None | $1.38 | $1.38 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $5.01 | Professional | None | $1.38 | $1.38 | $5.01 |
Ambetter Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.23 Median $1.26 Typical High $3.39 | Professional | None | $1.23 | $1.26 | $3.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.81 Median $0.95 Typical High $1.35 | Professional | UE · Used equipment | $0.81 | $0.95 | $1.35 |
Aultcare Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
CareSource Setting Facility Modifier None Typical Low $1.05 Median $1.55 Typical High $2.09 | Facility | None | $1.05 | $1.55 | $2.09 |
CareSource Setting Professional Modifier None Typical Low $1.35 Median $1.86 Typical High $2.82 | Professional | None | $1.35 | $1.86 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.74 | Facility | None | $1.41 | $1.41 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | None | $1.20 | $1.20 | $1.41 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.74 | Facility | None | $1.41 | $1.41 | $1.74 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.41 | Professional | None | $1.20 | $1.20 | $1.41 |
Molina Setting Professional Modifier None Typical Low $1.17 Median $1.62 Typical High $1.78 | Professional | None | $1.17 | $1.62 | $1.78 |
SummaCare Setting Professional Modifier None Typical Low $2.19 Median $2.24 Typical High $3.47 | Professional | None | $2.19 | $2.24 | $3.47 |
United Setting Professional Modifier None Typical Low $0.72 Median $1.05 Typical High $1.55 | Professional | None | $0.72 | $1.05 | $1.55 |
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 $0.21 Median $0.21 Typical High $0.76 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | RR · Rental | $0.12 | $0.12 | $0.13 |
Where Ohio sits
The same service costs 5.4 times more in Kansas than in Kentucky. 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· 39th of 51
$1.26
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.