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 $5.75 Median $5.75 Typical High $25.70 | Facility | None | $5.75 | $5.75 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $19.95 | Professional | None | $5.75 | $5.75 | $19.95 |
Ambetter Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $5.01 Typical High $13.49 | Professional | None | $4.57 | $5.01 | $13.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.39 Median $4.57 Typical High $4.90 | Professional | UE · Used equipment | $3.39 | $4.57 | $4.90 |
Aultcare Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
CareSource Setting Facility Modifier None Typical Low $4.57 Median $6.76 Typical High $9.12 | Facility | None | $4.57 | $6.76 | $9.12 |
CareSource Setting Professional Modifier None Typical Low $5.89 Median $8.13 Typical High $12.30 | Professional | None | $5.89 | $8.13 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Facility | None | $5.50 | $5.50 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Facility | None | $5.50 | $5.50 | $5.75 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
Molina Setting Professional Modifier None Typical Low $5.75 Median $7.94 Typical High $10.72 | Professional | None | $5.75 | $7.94 | $10.72 |
SummaCare Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $14.79 | Professional | None | $9.33 | $9.33 | $14.79 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.37 Typical High $6.61 | Professional | None | $2.95 | $4.37 | $6.61 |
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 $2.88 Median $2.88 Typical High $10.00 | Professional | 52 · Reduced service | $2.88 | $2.88 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.15 Typical High $3.98 | Professional | 53 · Discontinued | $1.15 | $1.15 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $3.02 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.58 Typical High $2.00 | Professional | 56 · Pre-op care only | $0.58 | $0.58 | $2.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.46 Median $0.46 Typical High $0.50 | Professional | RR · Rental | $0.46 | $0.46 | $0.50 |
Where Ohio sits
The same service costs 2.3 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· 38th of 51
$5.01
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.