How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.39 Median $0.39 Typical High $3.02 | Facility | None | $0.39 | $0.39 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.60 | Professional | None | $0.39 | $0.39 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.09 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.06 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.10 Median $0.10 Typical High $0.15 | Professional | None | $0.10 | $0.10 | $0.15 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Molina Setting Professional Modifier None Typical Low $0.62 Median $0.72 Typical High $1.10 | Professional | None | $0.62 | $0.72 | $1.10 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $0.27 Median $0.40 Typical High $0.56 | Professional | None | $0.27 | $0.40 | $0.56 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.18 Median $0.26 Typical High $0.34 | Professional | UE · Used equipment | $0.18 | $0.26 | $0.34 |
Where Ohio sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 51st of 51
$0.39
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.