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 $0.20 Median $0.20 Typical High $1.00 | Facility | None | $0.20 | $0.20 | $1.00 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.28 | Professional | None | $0.20 | $0.20 | $0.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.26 Median $0.52 Typical High $1.00 | Professional | None | $0.26 | $0.52 | $1.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.22 Median $0.26 Typical High $0.38 | Professional | UE · Used equipment | $0.22 | $0.26 | $0.38 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Molina Setting Professional Modifier None Typical Low $0.13 Median $50.12 Typical High $60.26 | Professional | None | $0.13 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $0.13 Median $0.20 Typical High $0.28 | Professional | None | $0.13 | $0.20 | $0.28 |
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 $0.03 Median $0.03 Typical High $0.04 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | RR · Rental | $0.03 | $0.03 | $0.03 |
Where Ohio sits
The same service costs 15.5 times more in Minnesota than in Hawaii. 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· 30th of 51
$0.28
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.