How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.07 Median $4.07 Typical High $19.95 | Facility | None | $4.07 | $4.07 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.37 | Professional | None | $4.07 | $4.07 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $37.15 | Professional | None | $19.95 | $23.44 | $37.15 |
CareSource Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
CareSource Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | None | $29.51 | $29.51 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
SummaCare Setting Professional Modifier None Typical Low $23.44 Median $27.54 Typical High $37.15 | Professional | None | $23.44 | $27.54 | $37.15 |
United Setting Professional Modifier None Typical Low $8.91 Median $14.13 Typical High $18.62 | Professional | None | $8.91 | $14.13 | $18.62 |
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 $2.04 Median $2.04 Typical High $2.19 | Professional | 52 · Reduced service | $2.04 | $2.04 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $0.87 | Professional | 53 · Discontinued | $0.81 | $0.81 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.66 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.96 Median $10.96 Typical High $16.98 | Professional | UE · Used equipment | $10.96 | $10.96 | $16.98 |
Where Ohio sits
The same service costs 6.9 times more in Montana than in Indiana. 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· 11th of 51
$19.95
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.