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 $0.34 Median $0.34 Typical High $3.98 | Facility | None | $0.34 | $0.34 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $3.98 | Professional | None | $0.34 | $0.34 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.43 Median $0.50 Typical High $0.78 | Facility | None | $0.43 | $0.50 | $0.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.31 Median $0.63 Typical High $1.55 | Professional | None | $0.31 | $0.63 | $1.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.33 Median $0.38 Typical High $0.44 | Professional | UE · Used equipment | $0.33 | $0.38 | $0.44 |
CareSource Setting Facility Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
CareSource Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
Cigna Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | None | $0.33 | $0.33 | $0.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.45 | Professional | None | $0.33 | $0.33 | $0.45 |
Molina Setting Professional Modifier None Typical Low $0.71 Median $0.87 Typical High $1.15 | Professional | None | $0.71 | $0.87 | $1.15 |
SummaCare Setting Professional Modifier None Typical Low $0.60 Median $0.71 Typical High $1.41 | Professional | None | $0.60 | $0.71 | $1.41 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.62 Typical High $0.98 | Professional | None | $0.18 | $0.62 | $0.98 |
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 $0.05 Median $0.05 Typical High $0.60 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.40 |
Where Ohio sits
The same service costs 3.0 times more in Florida 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· 27th of 51
$0.48
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.