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 $26.92 Median $26.92 Typical High $79.43 | Facility | None | $26.92 | $26.92 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $75.86 | Professional | None | $26.92 | $26.92 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.88 Median $38.90 Typical High $61.66 | Facility | None | $33.88 | $38.90 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $23.44 | Professional | None | $15.85 | $15.85 | $23.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | UE · Used equipment | $12.02 | $12.02 | $13.18 |
CareSource Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $42.66 | Professional | None | $31.62 | $31.62 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $18.20 Typical High $20.89 | Professional | None | $14.45 | $18.20 | $20.89 |
SummaCare Setting Professional Modifier None Typical Low $31.62 Median $37.15 Typical High $74.13 | Professional | None | $31.62 | $37.15 | $74.13 |
United Setting Professional Modifier None Typical Low $14.13 Median $24.55 Typical High $46.77 | Professional | None | $14.13 | $24.55 | $46.77 |
2 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 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $11.48 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $7.59 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $7.59 |
Where Ohio sits
The same service costs 3.5 times more in Montana than in New York. 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· 49th of 51
$15.85
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.