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 $5.37 Median $5.37 Typical High $26.92 | Facility | None | $5.37 | $5.37 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $26.92 | Professional | None | $5.37 | $5.37 | $26.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.47 Median $13.18 Typical High $23.99 | Facility | None | $10.47 | $13.18 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $6.92 Typical High $15.85 | Professional | None | $5.01 | $6.92 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.07 Median $5.01 Typical High $6.03 | Professional | UE · Used equipment | $4.07 | $5.01 | $6.03 |
Aultcare Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
CareSource Setting Facility Modifier None Typical Low $5.50 Median $8.32 Typical High $10.96 | Facility | None | $5.50 | $8.32 | $10.96 |
CareSource Setting Professional Modifier None Typical Low $7.24 Median $10.00 Typical High $14.79 | Professional | None | $7.24 | $10.00 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $6.46 Typical High $8.71 | Professional | None | $4.68 | $6.46 | $8.71 |
SummaCare Setting Professional Modifier None Typical Low $11.22 Median $11.48 Typical High $17.78 | Professional | None | $11.22 | $11.48 | $17.78 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $15.14 | Facility | None | $6.31 | $7.94 | $15.14 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.50 Typical High $8.51 | Professional | None | $3.72 | $5.50 | $8.51 |
5 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 $2.69 Median $2.69 Typical High $10.96 | Professional | 52 · Reduced service | $2.69 | $2.69 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $4.37 | Professional | 53 · Discontinued | $1.07 | $1.07 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.81 Typical High $3.31 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.54 Typical High $2.19 | Professional | 56 · Pre-op care only | $0.54 | $0.54 | $2.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.68 Median $0.68 Typical High $0.72 | Professional | RR · Rental | $0.68 | $0.68 | $0.72 |
Where Ohio sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 33rd of 51
$6.92
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.