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 $3.16 Median $3.16 Typical High $7.08 | Facility | None | $3.16 | $3.16 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $7.08 | Professional | None | $3.16 | $3.16 | $7.08 |
Ambetter Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $2.88 Typical High $7.59 | Professional | None | $2.63 | $2.88 | $7.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.86 Median $2.51 Typical High $2.69 | Professional | UE · Used equipment | $1.86 | $2.51 | $2.69 |
Aultcare Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
CareSource Setting Facility Modifier None Typical Low $2.51 Median $3.80 Typical High $5.01 | Facility | None | $2.51 | $3.80 | $5.01 |
CareSource Setting Professional Modifier None Typical Low $3.24 Median $4.47 Typical High $6.76 | Professional | None | $3.24 | $4.47 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.16 | Facility | None | $3.02 | $3.02 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.16 | Facility | None | $3.02 | $3.02 | $3.16 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Molina Setting Professional Modifier None Typical Low $3.24 Median $4.37 Typical High $5.89 | Professional | None | $3.24 | $4.37 | $5.89 |
SummaCare Setting Professional Modifier None Typical Low $5.13 Median $5.25 Typical High $8.13 | Professional | None | $5.13 | $5.25 | $8.13 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.40 Typical High $3.63 | Professional | None | $1.62 | $2.40 | $3.63 |
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 $1.58 Median $1.58 Typical High $3.47 | Professional | 52 · Reduced service | $1.58 | $1.58 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $1.41 | Professional | 53 · Discontinued | $0.65 | $0.65 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.48 Median $0.48 Typical High $1.05 | Professional | 55 · Aftercare only | $0.48 | $0.48 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.25 Median $0.25 Typical High $0.27 | Professional | RR · Rental | $0.25 | $0.25 | $0.27 |
Where Ohio sits
The same service costs 2.3 times more in Kansas than in Utah. 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· 37th of 51
$2.82
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.