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 $44.67 Typical High $151.36 | Facility | None | $26.92 | $44.67 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $141.25 | Professional | None | $26.92 | $26.92 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $60.26 Typical High $109.65 | Facility | None | $47.86 | $60.26 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $74.13 | Professional | None | $43.65 | $52.48 | $74.13 |
Aultcare Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $29.51 Median $44.67 Typical High $58.88 | Facility | None | $29.51 | $44.67 | $58.88 |
CareSource Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $79.43 | Professional | None | $38.02 | $52.48 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $54.95 | Facility | None | $52.48 | $52.48 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $54.95 | Facility | None | $52.48 | $52.48 | $54.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $104.71 | Professional | None | $56.23 | $77.62 | $104.71 |
SummaCare Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $112.20 | Professional | None | $77.62 | $83.18 | $112.20 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $112.20 | Facility | None | $79.43 | $79.43 | $112.20 |
United Setting Professional Modifier None Typical Low $28.18 Median $43.65 Typical High $63.10 | Professional | None | $28.18 | $43.65 | $63.10 |
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 $13.49 Median $13.49 Typical High $70.79 | Professional | 52 · Reduced service | $13.49 | $13.49 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $28.18 | Professional | 53 · Discontinued | $5.37 | $5.37 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $21.38 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $14.13 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $5.62 | Professional | RR · Rental | $5.37 | $5.37 | $5.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $40.74 | $40.74 | $40.74 |
Where Ohio sits
The same service costs 2.6 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· 37th of 51
$46.77
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.