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 $4.27 Median $4.27 Typical High $12.02 | Facility | None | $4.27 | $4.27 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $8.91 | Professional | None | $4.27 | $4.27 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.31 Median $3.63 Typical High $10.00 | Professional | None | $3.31 | $3.63 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.51 Median $3.31 Typical High $3.63 | Professional | UE · Used equipment | $2.51 | $3.31 | $3.63 |
Aultcare Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
CareSource Setting Facility Modifier None Typical Low $3.31 Median $5.01 Typical High $6.61 | Facility | None | $3.31 | $5.01 | $6.61 |
CareSource Setting Professional Modifier None Typical Low $4.37 Median $6.03 Typical High $8.91 | Professional | None | $4.37 | $6.03 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Molina Setting Professional Modifier None Typical Low $1.95 Median $2.69 Typical High $3.63 | Professional | None | $1.95 | $2.69 | $3.63 |
SummaCare Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $10.72 | Professional | None | $6.76 | $6.76 | $10.72 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.16 Typical High $4.79 | Professional | None | $2.19 | $3.16 | $4.79 |
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 $2.09 Median $2.09 Typical High $4.47 | Professional | 52 · Reduced service | $2.09 | $2.09 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $1.82 | Professional | 53 · Discontinued | $0.83 | $0.83 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.63 Typical High $1.35 | Professional | 55 · Aftercare only | $0.63 | $0.63 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.33 Median $0.33 Typical High $0.36 | Professional | RR · Rental | $0.33 | $0.33 | $0.36 |
Where Ohio sits
The same service costs 2.1 times more in Kansas than in Alabama. 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· 42nd of 51
$3.55
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.