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 $2.40 Median $2.40 Typical High $8.91 | Facility | None | $2.40 | $2.40 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $5.01 | Professional | None | $2.40 | $2.40 | $5.01 |
Ambetter Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.00 Median $2.04 Typical High $5.75 | Professional | None | $2.00 | $2.04 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.41 Median $1.62 Typical High $2.14 | Professional | UE · Used equipment | $1.41 | $1.62 | $2.14 |
Aultcare Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
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 $3.39 Median $5.13 Typical High $6.03 | Professional | None | $3.39 | $5.13 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.40 | Facility | None | $2.29 | $2.29 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.29 | Professional | None | $1.95 | $1.95 | $2.29 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.40 | Facility | None | $2.29 | $2.29 | $2.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.29 | Professional | None | $1.95 | $1.95 | $2.29 |
Molina Setting Professional Modifier None Typical Low $2.14 Median $2.95 Typical High $3.98 | Professional | None | $2.14 | $2.95 | $3.98 |
SummaCare Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $6.17 | Professional | None | $3.89 | $3.89 | $6.17 |
United Setting Professional Modifier None Typical Low $1.23 Median $1.82 Typical High $2.75 | Professional | None | $1.23 | $1.82 | $2.75 |
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 $0.36 Median $0.36 Typical High $0.76 | Professional | 55 · Aftercare only | $0.36 | $0.36 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.24 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.24 | $0.24 | $0.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.19 Median $0.19 Typical High $0.21 | Professional | RR · Rental | $0.19 | $0.19 | $0.21 |
Where Ohio sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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
$2.04
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.