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 $10.47 Median $10.47 Typical High $42.66 | Facility | None | $10.47 | $10.47 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $33.88 | Professional | None | $10.47 | $10.47 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.08 Median $8.32 Typical High $22.91 | Professional | None | $7.08 | $8.32 | $22.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.37 Median $7.59 Typical High $8.71 | Professional | UE · Used equipment | $5.37 | $7.59 | $8.71 |
CareSource Setting Facility Modifier None Typical Low $7.08 Median $10.72 Typical High $14.13 | Facility | None | $7.08 | $10.72 | $14.13 |
CareSource Setting Professional Modifier None Typical Low $9.12 Median $12.59 Typical High $19.05 | Professional | None | $9.12 | $12.59 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
Molina Setting Professional Modifier None Typical Low $8.51 Median $11.75 Typical High $15.85 | Professional | None | $8.51 | $11.75 | $15.85 |
SummaCare Setting Professional Modifier None Typical Low $16.98 Median $17.38 Typical High $26.92 | Professional | None | $16.98 | $17.38 | $26.92 |
United Setting Professional Modifier None Typical Low $5.37 Median $7.94 Typical High $12.02 | Professional | None | $5.37 | $7.94 | $12.02 |
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 $1.58 Median $1.58 Typical High $5.13 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $3.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.71 Median $0.71 Typical High $0.78 | Professional | RR · Rental | $0.71 | $0.71 | $0.78 |
Where Ohio sits
The same service costs 2.3 times more in Montana 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· 42nd of 51
$8.51
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.