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 $1.58 Median $1.58 Typical High $6.03 | Facility | None | $1.58 | $1.58 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $5.01 | Professional | None | $1.58 | $1.58 | $5.01 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.32 Median $1.35 Typical High $3.72 | Professional | None | $1.32 | $1.35 | $3.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.93 Median $1.07 Typical High $1.55 | Professional | UE · Used equipment | $0.93 | $1.07 | $1.55 |
Aultcare Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
CareSource Setting Facility Modifier None Typical Low $1.26 Median $1.86 Typical High $2.51 | Facility | None | $1.26 | $1.86 | $2.51 |
CareSource Setting Professional Modifier None Typical Low $1.62 Median $2.24 Typical High $3.39 | Professional | None | $1.62 | $2.24 | $3.39 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.58 | Facility | None | $1.51 | $1.51 | $1.58 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.51 | Professional | None | $1.29 | $1.29 | $1.51 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.58 | Facility | None | $1.51 | $1.51 | $1.58 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.51 | Professional | None | $1.29 | $1.29 | $1.51 |
Molina Setting Professional Modifier None Typical Low $1.45 Median $1.95 Typical High $2.14 | Professional | None | $1.45 | $1.95 | $2.14 |
SummaCare Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $4.07 | Professional | None | $2.57 | $2.57 | $4.07 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.20 Typical High $1.82 | Professional | None | $0.81 | $1.20 | $1.82 |
3 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 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.76 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | RR · Rental | $0.13 | $0.13 | $0.14 |
Where Ohio sits
The same service costs 2.1 times more in Idaho 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· 44th of 51
$1.32
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.