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 $2.95 Median $2.95 Typical High $8.91 | Facility | None | $2.95 | $2.95 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $7.08 | Professional | None | $2.95 | $2.95 | $7.08 |
Ambetter Setting Professional Modifier None Typical Low $3.24 Median $3.63 Typical High $3.80 | Professional | None | $3.24 | $3.63 | $3.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.45 Median $2.57 Typical High $7.08 | Professional | None | $2.45 | $2.57 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.74 Median $2.29 Typical High $2.57 | Professional | UE · Used equipment | $1.74 | $2.29 | $2.57 |
CareSource Setting Facility Modifier None Typical Low $2.19 Median $3.24 Typical High $4.37 | Facility | None | $2.19 | $3.24 | $4.37 |
CareSource Setting Professional Modifier None Typical Low $2.82 Median $3.89 Typical High $5.89 | Professional | None | $2.82 | $3.89 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.19 | Professional | None | $1.91 | $2.19 | $2.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.19 | Professional | None | $1.91 | $2.19 | $2.19 |
Molina Setting Professional Modifier None Typical Low $2.40 Median $3.31 Typical High $4.47 | Professional | None | $2.40 | $3.31 | $4.47 |
SummaCare Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $7.41 | Professional | None | $4.68 | $4.68 | $7.41 |
United Setting Professional Modifier None Typical Low $1.51 Median $2.19 Typical High $3.39 | Professional | None | $1.51 | $2.19 | $3.39 |
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 $0.44 Median $0.44 Typical High $1.05 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.71 |
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 2.5 times more in Hawaii than in Vermont. 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· 29th of 51
$2.45
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.