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 $0.28 Median $0.28 Typical High $3.98 | Facility | None | $0.28 | $0.28 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $2.00 | Professional | None | $0.28 | $0.28 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.37 Median $0.42 Typical High $0.66 | Facility | None | $0.37 | $0.42 | $0.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.26 Median $0.60 Typical High $1.51 | Professional | None | $0.26 | $0.60 | $1.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.28 Median $0.35 Typical High $0.37 | Professional | UE · Used equipment | $0.28 | $0.35 | $0.37 |
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 $0.24 Median $0.24 Typical High $0.24 | Professional | None | $0.24 | $0.24 | $0.24 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.38 | Professional | None | $0.24 | $0.24 | $0.38 |
Molina Setting Professional Modifier None Typical Low $0.58 Median $0.71 Typical High $0.93 | Professional | None | $0.58 | $0.71 | $0.93 |
SummaCare Setting Professional Modifier None Typical Low $0.49 Median $0.58 Typical High $1.15 | Professional | None | $0.49 | $0.58 | $1.15 |
United Setting Professional Modifier None Typical Low $0.15 Median $0.51 Typical High $0.81 | Professional | None | $0.15 | $0.51 | $0.81 |
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 $0.04 Median $0.04 Typical High $0.30 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.20 |
Where Ohio sits
The same service costs 3.1 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· 24th of 51
$0.41
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.