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 $2.82 Median $2.82 Typical High $12.88 | Facility | None | $2.82 | $2.82 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $10.00 | Professional | None | $2.82 | $2.82 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $2.45 Typical High $6.76 | Professional | None | $2.24 | $2.45 | $6.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.66 Median $2.24 Typical High $2.45 | Professional | UE · Used equipment | $1.66 | $2.24 | $2.45 |
CareSource Setting Facility Modifier None Typical Low $1.91 Median $2.82 Typical High $3.80 | Facility | None | $1.91 | $2.82 | $3.80 |
CareSource Setting Professional Modifier None Typical Low $2.45 Median $3.39 Typical High $5.13 | Professional | None | $2.45 | $3.39 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
Molina Setting Professional Modifier None Typical Low $1.10 Median $1.51 Typical High $2.04 | Professional | None | $1.10 | $1.51 | $2.04 |
SummaCare Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $7.24 | Professional | None | $4.57 | $4.57 | $7.24 |
United Setting Professional Modifier None Typical Low $1.32 Median $2.14 Typical High $3.24 | Professional | None | $1.32 | $2.14 | $3.24 |
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 $1.41 Median $1.41 Typical High $5.01 | Professional | 52 · Reduced service | $1.41 | $1.41 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $2.00 | Professional | 53 · Discontinued | $0.56 | $0.56 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.42 Typical High $1.51 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $1.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.23 Median $0.23 Typical High $0.25 | Professional | RR · Rental | $0.23 | $0.23 | $0.25 |
Where Ohio sits
The same service costs 2.1 times more in Montana than in New Hampshire. 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
$2.29
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.