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 $3.31 Median $3.31 Typical High $12.02 | Facility | None | $3.31 | $3.31 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $8.91 | Professional | None | $3.31 | $3.31 | $8.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $2.95 Typical High $7.94 | Professional | None | $2.63 | $2.95 | $7.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.95 Median $2.57 Typical High $2.88 | Professional | UE · Used equipment | $1.95 | $2.57 | $2.88 |
CareSource Setting Facility Modifier None Typical Low $2.63 Median $3.98 Typical High $5.25 | Facility | None | $2.63 | $3.98 | $5.25 |
CareSource Setting Professional Modifier None Typical Low $3.39 Median $4.68 Typical High $7.08 | Professional | None | $3.39 | $4.68 | $7.08 |
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 $2.40 Median $3.31 Typical High $4.47 | Professional | None | $2.40 | $3.31 | $4.47 |
SummaCare Setting Professional Modifier None Typical Low $5.37 Median $5.50 Typical High $8.51 | Professional | None | $5.37 | $5.50 | $8.51 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.51 Typical High $3.80 | Professional | None | $1.74 | $2.51 | $3.80 |
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 $1.66 Median $1.66 Typical High $4.47 | Professional | 52 · Reduced service | $1.66 | $1.66 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $1.82 | Professional | 53 · Discontinued | $0.68 | $0.68 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.50 Typical High $1.35 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.26 Typical High $0.28 | Professional | RR · Rental | $0.26 | $0.26 | $0.28 |
Where Ohio sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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· 39th of 51
$2.95
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.