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 $1.23 Median $1.23 Typical High $6.03 | Facility | None | $1.23 | $1.23 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.70 | Professional | None | $1.23 | $1.23 | $1.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.68 Median $1.23 Typical High $2.95 | Professional | None | $0.68 | $1.23 | $2.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.71 Median $0.81 Typical High $1.07 | Professional | UE · Used equipment | $0.71 | $0.81 | $1.07 |
CareSource Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
CareSource Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.63 | Professional | None | $2.51 | $2.51 | $2.63 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Molina Setting Professional Modifier None Typical Low $1.00 Median $1.38 Typical High $2.04 | Professional | None | $1.00 | $1.38 | $2.04 |
SummaCare Setting Professional Modifier None Typical Low $1.70 Median $2.00 Typical High $2.75 | Professional | None | $1.70 | $2.00 | $2.75 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.98 Typical High $1.17 | Professional | None | $0.65 | $0.98 | $1.17 |
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 $0.62 Median $0.62 Typical High $0.87 | Professional | 52 · Reduced service | $0.62 | $0.62 | $0.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $0.35 | Professional | 53 · Discontinued | $0.25 | $0.25 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.26 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.09 Median $0.09 Typical High $0.12 | Professional | RR · Rental | $0.09 | $0.09 | $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· 44th of 51
$1.00
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.