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 $8.71 Median $8.71 Typical High $30.20 | Facility | None | $8.71 | $8.71 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $28.18 | Professional | None | $8.71 | $8.71 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.96 Median $12.59 Typical High $19.95 | Facility | None | $10.96 | $12.59 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $6.61 | Professional | None | $4.17 | $4.17 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.09 Median $3.09 Typical High $4.07 | Professional | UE · Used equipment | $3.09 | $3.09 | $4.07 |
CareSource Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $13.80 | Professional | None | $10.23 | $10.23 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Molina Setting Professional Modifier None Typical Low $4.57 Median $5.62 Typical High $6.61 | Professional | None | $4.57 | $5.62 | $6.61 |
SummaCare Setting Professional Modifier None Typical Low $10.00 Median $11.75 Typical High $23.44 | Professional | None | $10.00 | $11.75 | $23.44 |
United Setting Professional Modifier None Typical Low $4.57 Median $7.94 Typical High $14.79 | Professional | None | $4.57 | $7.94 | $14.79 |
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 $1.29 Median $1.29 Typical High $4.17 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $2.82 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $2.82 |
Where Ohio sits
The same service costs 4.6 times more in Florida than in New York. 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· 50th of 51
$4.17
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.