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 $5.13 Median $14.13 Typical High $16.98 | Facility | None | $5.13 | $14.13 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $10.96 | Professional | None | $5.13 | $5.13 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.98 Median $4.27 Typical High $10.72 | Professional | None | $3.98 | $4.27 | $10.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.02 Typical High $4.57 | Professional | UE · Used equipment | $3.02 | $3.02 | $4.57 |
Aultcare Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
CareSource Setting Facility Modifier None Typical Low $3.98 Median $6.03 Typical High $7.94 | Facility | None | $3.98 | $6.03 | $7.94 |
CareSource Setting Professional Modifier None Typical Low $7.24 Median $10.72 Typical High $12.88 | Professional | None | $7.24 | $10.72 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.79 | Professional | None | $4.07 | $4.07 | $4.79 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.79 | Professional | None | $4.07 | $4.07 | $4.79 |
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 $8.13 Median $8.13 Typical High $12.88 | Professional | None | $8.13 | $8.13 | $12.88 |
United Setting Professional Modifier None Typical Low $2.63 Median $3.80 Typical High $5.75 | Professional | None | $2.63 | $3.80 | $5.75 |
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 $0.76 Median $0.76 Typical High $1.66 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $1.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.40 Median $0.40 Typical High $0.43 | Professional | RR · Rental | $0.40 | $0.40 | $0.43 |
Where Ohio sits
The same service costs 2.3 times more in Kansas than in Utah. 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
$4.27
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.