How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1.66 Median $1.66 Typical High $3.98 | Facility | None | $1.66 | $1.66 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $2.24 | Professional | None | $1.66 | $1.66 | $2.24 |
Ambetter Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | None | $1.70 | $1.70 | $1.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $1.58 Typical High $3.98 | Professional | None | $0.89 | $1.58 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.89 Median $1.07 Typical High $1.38 | Professional | UE · Used equipment | $0.89 | $1.07 | $1.38 |
CareSource Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
CareSource Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | None | $3.39 | $3.39 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Molina Setting Professional Modifier None Typical Low $1.66 Median $2.29 Typical High $3.47 | Professional | None | $1.66 | $2.29 | $3.47 |
SummaCare Setting Professional Modifier None Typical Low $2.24 Median $2.63 Typical High $3.63 | Professional | None | $2.24 | $2.63 | $3.63 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.29 Typical High $1.58 | Professional | None | $0.87 | $1.29 | $1.58 |
6 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 52 · Reduced service Typical Low $0.83 Median $0.83 Typical High $1.12 | Professional | 52 · Reduced service | $0.83 | $0.83 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.33 Typical High $0.45 | Professional | 53 · Discontinued | $0.33 | $0.33 | $0.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $0.34 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.22 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | A1 · Dressing, 1 wound | $2.00 | $2.00 | $2.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.12 Median $0.12 Typical High $0.16 | Professional | RR · Rental | $0.12 | $0.12 | $0.16 |
Where Ohio sits
The same service costs 2.6 times more in Hawaii 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· 46th 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.