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 $7.76 Median $7.76 Typical High $18.20 | Facility | None | $7.76 | $7.76 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $18.20 | Professional | None | $7.76 | $7.76 | $18.20 |
Ambetter Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.17 Median $6.46 Typical High $15.85 | Professional | None | $6.17 | $6.46 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.57 Median $4.57 Typical High $6.61 | Professional | UE · Used equipment | $4.57 | $4.57 | $6.61 |
Aultcare Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
CareSource Setting Facility Modifier None Typical Low $6.17 Median $9.12 Typical High $12.30 | Facility | None | $6.17 | $9.12 | $12.30 |
CareSource Setting Professional Modifier None Typical Low $10.96 Median $16.60 Typical High $19.50 | Professional | None | $10.96 | $16.60 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.76 | Facility | None | $7.41 | $7.41 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | None | $6.31 | $6.31 | $7.41 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.76 | Facility | None | $7.41 | $7.41 | $7.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | None | $6.31 | $6.31 | $7.41 |
Molina Setting Professional Modifier None Typical Low $6.46 Median $8.91 Typical High $12.02 | Professional | None | $6.46 | $8.91 | $12.02 |
SummaCare Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $19.50 | Professional | None | $12.59 | $12.59 | $19.50 |
United Setting Professional Modifier None Typical Low $3.98 Median $5.89 Typical High $8.91 | Professional | None | $3.98 | $5.89 | $8.91 |
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 $1.17 Median $1.17 Typical High $2.69 | Professional | 55 · Aftercare only | $1.17 | $1.17 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.78 Typical High $1.82 | Professional | 56 · Pre-op care only | $0.78 | $0.78 | $1.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.62 Median $0.62 Typical High $0.66 | Professional | RR · Rental | $0.62 | $0.62 | $0.66 |
Where Ohio sits
The same service costs 2.0 times more in Montana than in Florida. 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· 44th of 51
$6.46
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.