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 $69.18 Median $69.18 Typical High $245.47 | Facility | None | $69.18 | $69.18 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $190.55 | Professional | None | $69.18 | $69.18 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $138.04 | Professional | None | $52.48 | $66.07 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.90 Median $43.65 Typical High $57.54 | Professional | UE · Used equipment | $38.90 | $43.65 | $57.54 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $81.28 Typical High $107.15 | Facility | None | $53.70 | $81.28 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $144.54 | Professional | None | $70.79 | $97.72 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $128.82 | Professional | None | $69.18 | $95.50 | $128.82 |
SummaCare Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $173.78 | Professional | None | $109.65 | $112.20 | $173.78 |
United Setting Professional Modifier None Typical Low $31.62 Median $52.48 Typical High $77.62 | Professional | None | $31.62 | $52.48 | $77.62 |
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 $34.67 Median $34.67 Typical High $95.50 | Professional | 52 · Reduced service | $34.67 | $34.67 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $38.02 | Professional | 53 · Discontinued | $13.80 | $13.80 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $28.18 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $19.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $7.41 | Professional | RR · Rental | $6.92 | $6.92 | $7.41 |
Where Ohio sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 45th of 51
$60.26
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.