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 $38.90 Median $38.90 Typical High $158.49 | Facility | None | $38.90 | $38.90 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $147.91 | Professional | None | $38.90 | $38.90 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $85.11 Typical High $158.49 | Facility | None | $69.18 | $85.11 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $93.33 | Professional | None | $35.48 | $42.66 | $93.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $28.84 Typical High $38.02 | Professional | UE · Used equipment | $26.30 | $28.84 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $63.10 Typical High $85.11 | Facility | None | $42.66 | $63.10 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $114.82 | Professional | None | $54.95 | $75.86 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $56.23 | Professional | None | $30.90 | $41.69 | $56.23 |
SummaCare Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $117.49 | Professional | None | $74.13 | $74.13 | $117.49 |
United Setting Facility Modifier None Typical Low $19.05 Median $36.31 Typical High $97.72 | Facility | None | $19.05 | $36.31 | $97.72 |
United Setting Professional Modifier None Typical Low $23.99 Median $36.31 Typical High $52.48 | Professional | None | $23.99 | $36.31 | $52.48 |
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 $19.50 Median $19.50 Typical High $74.13 | Professional | 52 · Reduced service | $19.50 | $19.50 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $29.51 | Professional | 53 · Discontinued | $7.76 | $7.76 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $21.88 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $14.79 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $14.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | RR · Rental | $4.27 | $4.27 | $4.37 |
Where Ohio sits
The same service costs 2.9 times more in Kansas than in Delaware. 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· 47th of 51
$38.90
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.