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 $34.67 Median $34.67 Typical High $89.13 | Facility | None | $34.67 | $34.67 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $89.13 | Professional | None | $34.67 | $34.67 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $30.90 | Professional | None | $28.84 | $28.84 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $60.26 Typical High $93.33 | Facility | None | $51.29 | $60.26 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $74.13 | Professional | None | $30.90 | $39.81 | $74.13 |
Aultcare Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $26.92 Median $40.74 Typical High $53.70 | Facility | None | $26.92 | $40.74 | $53.70 |
CareSource Setting Professional Modifier None Typical Low $35.48 Median $48.98 Typical High $72.44 | Professional | None | $35.48 | $48.98 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $52.48 | Professional | None | $28.84 | $38.90 | $52.48 |
SummaCare Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $89.13 | Professional | None | $54.95 | $60.26 | $89.13 |
United Setting Professional Modifier None Typical Low $17.78 Median $26.30 Typical High $38.90 | Professional | None | $17.78 | $26.30 | $38.90 |
6 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 $16.98 Median $16.98 Typical High $44.67 | Professional | 52 · Reduced service | $16.98 | $16.98 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $18.20 | Professional | 53 · Discontinued | $6.92 | $6.92 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $13.49 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $8.91 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $8.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $3.31 | Professional | RR · Rental | $3.09 | $3.09 | $3.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $22.91 Typical High $25.12 | Professional | UE · Used equipment | $22.91 | $22.91 | $25.12 |
Where Ohio sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 29th of 51
$35.48
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.