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 $2.45 Median $2.45 Typical High $12.88 | Facility | None | $2.45 | $2.45 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $7.08 | Professional | None | $2.45 | $2.45 | $7.08 |
Ambetter Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $2.14 Typical High $5.89 | Professional | None | $2.04 | $2.14 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.45 Median $1.95 Typical High $2.19 | Professional | UE · Used equipment | $1.45 | $1.95 | $2.19 |
Aultcare Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
CareSource Setting Facility Modifier None Typical Low $1.95 Median $2.95 Typical High $3.89 | Facility | None | $1.95 | $2.95 | $3.89 |
CareSource Setting Professional Modifier None Typical Low $2.51 Median $3.55 Typical High $5.25 | Professional | None | $2.51 | $3.55 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.34 | Professional | None | $2.00 | $2.00 | $2.34 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.34 | Professional | None | $2.00 | $2.00 | $2.34 |
Molina Setting Professional Modifier None Typical Low $1.70 Median $2.34 Typical High $3.16 | Professional | None | $1.70 | $2.34 | $3.16 |
SummaCare Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $6.31 | Professional | None | $3.98 | $3.98 | $6.31 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.86 Typical High $2.82 | Professional | None | $1.26 | $1.86 | $2.82 |
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 $1.23 Median $1.23 Typical High $3.47 | Professional | 52 · Reduced service | $1.23 | $1.23 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $1.41 | Professional | 53 · Discontinued | $0.50 | $0.50 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $1.05 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.20 Median $0.20 Typical High $0.22 | Professional | RR · Rental | $0.20 | $0.20 | $0.22 |
Where Ohio sits
The same service costs 2.2 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· 40th of 51
$2.09
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.