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 $27.54 Median $27.54 Typical High $85.11 | Facility | None | $27.54 | $27.54 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $27.54 Typical High $50.12 | Professional | None | $26.30 | $27.54 | $50.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $19.50 Typical High $38.02 | Professional | None | $14.13 | $19.50 | $38.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.30 Median $14.79 Typical High $20.89 | Professional | UE · Used equipment | $12.30 | $14.79 | $20.89 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | None | $56.23 | $56.23 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $33.88 Typical High $51.29 | Professional | None | $24.55 | $33.88 | $51.29 |
SummaCare Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $70.79 | Professional | None | $37.15 | $43.65 | $70.79 |
United Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $18.62 | Professional | None | $13.80 | $15.14 | $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 $13.80 Median $13.80 Typical High $21.88 | Professional | 52 · Reduced service | $13.80 | $13.80 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $8.71 | Professional | 53 · Discontinued | $5.50 | $5.50 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $6.46 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $4.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.91 Median $1.91 Typical High $2.57 | Professional | RR · Rental | $1.91 | $1.91 | $2.57 |
Where Ohio sits
The same service costs 3.2 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· 43rd of 51
$19.50
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.