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 $1.45 Median $1.45 Typical High $3.98 | Facility | None | $1.45 | $1.45 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $3.02 | Professional | None | $1.45 | $1.45 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.82 Median $2.14 Typical High $3.31 | Facility | None | $1.82 | $2.14 | $3.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $2.29 Typical High $3.89 | Professional | None | $1.17 | $2.29 | $3.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.23 Median $1.41 Typical High $1.62 | Professional | UE · Used equipment | $1.23 | $1.41 | $1.62 |
Cigna Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.70 | Professional | None | $1.17 | $1.17 | $1.70 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.17 Median $1.70 Typical High $1.70 | Professional | None | $1.17 | $1.70 | $1.70 |
Molina Setting Professional Modifier None Typical Low $2.04 Median $2.57 Typical High $3.39 | Professional | None | $2.04 | $2.57 | $3.39 |
SummaCare Setting Professional Modifier None Typical Low $2.34 Median $2.95 Typical High $5.50 | Professional | None | $2.34 | $2.95 | $5.50 |
United Setting Professional Modifier None Typical Low $0.76 Median $2.24 Typical High $3.98 | Professional | None | $0.76 | $2.24 | $3.98 |
2 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 $0.22 Median $0.22 Typical High $0.45 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.30 |
Where Ohio sits
The same service costs 33.1 times more in Kansas than in Alabama. 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· 31st of 51
$1.95
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.