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 $6.46 | Facility | None | $3.16 | $3.16 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $6.03 | Professional | None | $3.16 | $3.16 | $6.03 |
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 $2.51 Median $2.75 Typical High $7.59 | Professional | None | $2.51 | $2.75 | $7.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.78 Median $2.04 Typical High $2.75 | Professional | UE · Used equipment | $1.78 | $2.04 | $2.75 |
Aultcare Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
CareSource Setting Facility Modifier None Typical Low $2.45 Median $3.72 Typical High $4.90 | Facility | None | $2.45 | $3.72 | $4.90 |
CareSource Setting Professional Modifier None Typical Low $3.24 Median $4.47 Typical High $6.61 | Professional | None | $3.24 | $4.47 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $3.16 | Facility | None | $2.95 | $2.95 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.95 | Professional | None | $2.51 | $2.51 | $2.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $3.16 | Facility | None | $2.95 | $2.95 | $3.16 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.95 | Professional | None | $2.51 | $2.51 | $2.95 |
Molina Setting Professional Modifier None Typical Low $2.82 Median $3.89 Typical High $5.25 | Professional | None | $2.82 | $3.89 | $5.25 |
SummaCare Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $7.94 | Professional | None | $5.01 | $5.13 | $7.94 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.34 Typical High $3.55 | Professional | None | $1.62 | $2.34 | $3.55 |
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 $0.47 Median $0.47 Typical High $0.89 | Professional | 55 · Aftercare only | $0.47 | $0.47 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.24 Median $0.24 Typical High $0.26 | Professional | RR · Rental | $0.24 | $0.24 | $0.26 |
Where Ohio sits
The same service costs 2.1 times more in Montana than in Colorado. 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
$2.69
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.