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 $5.25 Median $5.25 Typical High $12.02 | Facility | None | $5.25 | $5.25 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $3.98 Typical High $11.48 | Professional | None | $2.88 | $3.98 | $11.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.95 Median $3.63 Typical High $4.27 | Professional | UE · Used equipment | $2.95 | $3.63 | $4.27 |
CareSource Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
CareSource Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $11.22 | Professional | None | $10.72 | $10.72 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Molina Setting Professional Modifier None Typical Low $4.27 Median $5.89 Typical High $8.71 | Professional | None | $4.27 | $5.89 | $8.71 |
SummaCare Setting Professional Modifier None Typical Low $7.08 Median $8.32 Typical High $11.48 | Professional | None | $7.08 | $8.32 | $11.48 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.07 Typical High $5.01 | Professional | None | $2.75 | $4.07 | $5.01 |
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 $2.63 Median $2.63 Typical High $3.47 | Professional | 52 · Reduced service | $2.63 | $2.63 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.05 Typical High $1.41 | Professional | 53 · Discontinued | $1.05 | $1.05 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $1.05 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.71 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | A1 · Dressing, 1 wound | $4.37 | $4.37 | $4.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.37 Median $0.37 Typical High $0.49 | Professional | RR · Rental | $0.37 | $0.37 | $0.49 |
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· 35th of 51
$4.27
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.