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 $1.12 Median $3.09 Typical High $14.13 | Facility | None | $1.12 | $3.09 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.74 | Professional | None | $1.12 | $1.12 | $1.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.62 Median $1.20 Typical High $2.82 | Professional | None | $0.62 | $1.20 | $2.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.65 Median $0.76 Typical High $1.00 | Professional | UE · Used equipment | $0.65 | $0.76 | $1.00 |
CareSource Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
CareSource Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.34 | Professional | None | $2.29 | $2.29 | $2.34 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Molina Setting Professional Modifier None Typical Low $0.95 Median $1.32 Typical High $2.00 | Professional | None | $0.95 | $1.32 | $2.00 |
SummaCare Setting Professional Modifier None Typical Low $1.51 Median $1.78 Typical High $2.45 | Professional | None | $1.51 | $1.78 | $2.45 |
United Setting Professional Modifier None Typical Low $0.59 Median $0.87 Typical High $1.10 | Professional | None | $0.59 | $0.87 | $1.10 |
4 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 $0.56 Median $0.56 Typical High $0.87 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.35 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.26 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.18 |
Where Ohio sits
The same service costs 2.5 times more in Idaho 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· 40th of 51
$0.89
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.