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 $6.03 | Facility | None | $1.62 | $1.62 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $3.98 | Professional | None | $1.62 | $1.62 | $3.98 |
Ambetter Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.41 Typical High $3.98 | Professional | None | $1.38 | $1.41 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.98 Median $1.29 Typical High $1.48 | Professional | UE · Used equipment | $0.98 | $1.29 | $1.48 |
Aultcare Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
CareSource Setting Facility Modifier None Typical Low $1.29 Median $1.95 Typical High $2.57 | Facility | None | $1.29 | $1.95 | $2.57 |
CareSource Setting Professional Modifier None Typical Low $1.70 Median $2.34 Typical High $3.47 | Professional | None | $1.70 | $2.34 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.66 | Facility | None | $1.55 | $1.55 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.66 | Facility | None | $1.55 | $1.55 | $1.66 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
Molina Setting Professional Modifier None Typical Low $1.07 Median $1.48 Typical High $2.00 | Professional | None | $1.07 | $1.48 | $2.00 |
SummaCare Setting Professional Modifier None Typical Low $2.63 Median $2.69 Typical High $4.17 | Professional | None | $2.63 | $2.69 | $4.17 |
United Setting Professional Modifier None Typical Low $0.85 Median $1.23 Typical High $1.86 | Professional | None | $0.85 | $1.23 | $1.86 |
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 $0.33 Median $0.33 Typical High $0.79 | Professional | 53 · Discontinued | $0.33 | $0.33 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $0.60 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $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 New Jersey. 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
$1.38
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.