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 $3.09 Median $3.09 Typical High $15.85 | Facility | None | $3.09 | $3.09 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $10.96 | Professional | None | $3.09 | $3.09 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.03 Median $7.41 Typical High $13.80 | Facility | None | $6.03 | $7.41 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.16 Median $3.55 Typical High $8.32 | Professional | None | $3.16 | $3.55 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.34 Median $3.16 Typical High $3.63 | Professional | UE · Used equipment | $2.34 | $3.16 | $3.63 |
CareSource Setting Facility Modifier None Typical Low $3.16 Median $4.79 Typical High $6.31 | Facility | None | $3.16 | $4.79 | $6.31 |
CareSource Setting Professional Modifier None Typical Low $4.07 Median $5.75 Typical High $8.51 | Professional | None | $4.07 | $5.75 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Molina Setting Professional Modifier None Typical Low $3.89 Median $5.37 Typical High $7.24 | Professional | None | $3.89 | $5.37 | $7.24 |
SummaCare Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $10.23 | Professional | None | $6.46 | $6.46 | $10.23 |
United Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $9.12 | Facility | None | $6.46 | $6.46 | $9.12 |
United Setting Professional Modifier None Typical Low $2.09 Median $3.16 Typical High $4.57 | Professional | None | $2.09 | $3.16 | $4.57 |
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 $1.55 Median $1.55 Typical High $5.50 | Professional | 52 · Reduced service | $1.55 | $1.55 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $2.19 | Professional | 53 · Discontinued | $0.62 | $0.62 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $1.66 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $1.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.37 | Professional | RR · Rental | $0.34 | $0.34 | $0.37 |
Where Ohio sits
The same service costs 4.9 times more in Kansas than in Delaware. 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· 37th of 51
$3.47
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.