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 $1.55 Median $4.27 Typical High $5.25 | Facility | None | $1.55 | $4.27 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $1.55 Typical High $3.02 | Professional | None | $1.51 | $1.55 | $3.02 |
Ambetter Setting Professional Modifier None Typical Low $1.48 Median $3.02 Typical High $3.31 | Professional | None | $1.48 | $3.02 | $3.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.85 Median $1.55 Typical High $3.72 | Professional | None | $0.85 | $1.55 | $3.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.89 Median $1.02 Typical High $1.35 | Professional | UE · Used equipment | $0.89 | $1.02 | $1.35 |
CareSource Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
CareSource Setting Professional Modifier None Typical Low $2.45 Median $3.31 Typical High $3.47 | Professional | None | $2.45 | $3.31 | $3.47 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1.15 Median $1.15 Typical High $2.00 | Facility | None | $1.15 | $1.15 | $2.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Molina Setting Professional Modifier None Typical Low $0.83 Median $1.15 Typical High $1.74 | Professional | None | $0.83 | $1.15 | $1.74 |
SummaCare Setting Professional Modifier None Typical Low $2.14 Median $2.51 Typical High $3.47 | Professional | None | $2.14 | $2.51 | $3.47 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.20 Typical High $1.48 | Professional | None | $0.81 | $1.20 | $1.48 |
5 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 $0.78 Median $0.78 Typical High $1.05 | Professional | 52 · Reduced service | $0.78 | $0.78 | $1.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.31 Typical High $0.42 | Professional | 53 · Discontinued | $0.31 | $0.31 | $0.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.32 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | RR · Rental | $0.11 | $0.11 | $0.12 |
Where Ohio sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 37th of 51
$1.26
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.