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 $1.62 Median $1.62 Typical High $5.01 | Facility | None | $1.62 | $1.62 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $3.98 | Professional | None | $1.62 | $1.62 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $3.55 | Professional | None | $1.26 | $1.26 | $3.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.95 Median $1.26 Typical High $1.45 | Professional | UE · Used equipment | $0.95 | $1.26 | $1.45 |
CareSource Setting Facility Modifier None Typical Low $1.26 Median $1.91 Typical High $2.51 | Facility | None | $1.26 | $1.91 | $2.51 |
CareSource Setting Professional Modifier None Typical Low $1.62 Median $2.29 Typical High $3.39 | Professional | None | $1.62 | $2.29 | $3.39 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.70 | Professional | None | $1.45 | $1.45 | $1.70 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.70 | Professional | None | $1.45 | $1.45 | $1.70 |
Molina Setting Professional Modifier None Typical Low $1.10 Median $1.51 Typical High $2.04 | Professional | None | $1.10 | $1.51 | $2.04 |
SummaCare Setting Professional Modifier None Typical Low $2.57 Median $2.63 Typical High $4.07 | Professional | None | $2.57 | $2.63 | $4.07 |
United Setting Professional Modifier None Typical Low $0.83 Median $1.20 Typical High $1.82 | Professional | None | $0.83 | $1.20 | $1.82 |
5 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 52 · Reduced service Typical Low $0.81 Median $0.81 Typical High $2.00 | Professional | 52 · Reduced service | $0.81 | $0.81 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.79 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.60 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | RR · Rental | $0.13 | $0.13 | $0.14 |
Where Ohio sits
The same service costs 2.3 times more in Kansas 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· 45th of 51
$1.45
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.