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 $3.02 Median $3.02 Typical High $12.88 | Facility | None | $3.02 | $3.02 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $10.00 | Professional | None | $3.02 | $3.02 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $2.63 Typical High $7.24 | Professional | None | $2.51 | $2.63 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.78 Median $2.34 Typical High $2.63 | Professional | UE · Used equipment | $1.78 | $2.34 | $2.63 |
Aultcare Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
CareSource Setting Facility Modifier None Typical Low $2.40 Median $3.55 Typical High $4.79 | Facility | None | $2.40 | $3.55 | $4.79 |
CareSource Setting Professional Modifier None Typical Low $3.09 Median $4.27 Typical High $6.46 | Professional | None | $3.09 | $4.27 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $3.02 | Facility | None | $2.88 | $2.88 | $3.02 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.88 | Professional | None | $2.45 | $2.45 | $2.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $3.02 | Facility | None | $2.88 | $2.88 | $3.02 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | None | $2.45 | $2.45 | $2.95 |
Molina Setting Professional Modifier None Typical Low $2.63 Median $3.63 Typical High $4.90 | Professional | None | $2.63 | $3.63 | $4.90 |
SummaCare Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $7.76 | Professional | None | $4.90 | $4.90 | $7.76 |
United Setting Professional Modifier None Typical Low $1.55 Median $2.29 Typical High $3.47 | Professional | None | $1.55 | $2.29 | $3.47 |
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 $0.45 Median $0.45 Typical High $1.51 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $1.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.24 Median $0.24 Typical High $0.26 | Professional | RR · Rental | $0.24 | $0.24 | $0.26 |
Where Ohio sits
The same service costs 2.8 times more in Kansas than in Delaware. 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· 38th of 51
$2.63
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.