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 $63.10 Median $63.10 Typical High $346.74 | Facility | None | $63.10 | $63.10 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $323.59 | Professional | None | $63.10 | $63.10 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $257.04 | Facility | None | $112.20 | $138.04 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $151.36 | Professional | None | $57.54 | $67.61 | $151.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $46.77 Typical High $63.10 | Professional | UE · Used equipment | $42.66 | $46.77 | $63.10 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $97.72 Typical High $131.83 | Facility | None | $66.07 | $97.72 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $177.83 | Professional | None | $85.11 | $117.49 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $93.33 | Professional | None | $50.12 | $67.61 | $93.33 |
SummaCare Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $190.55 | Professional | None | $120.23 | $120.23 | $190.55 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $158.49 | Facility | None | $77.62 | $87.10 | $158.49 |
United Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $87.10 | Professional | None | $38.90 | $57.54 | $87.10 |
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 $31.62 Median $31.62 Typical High $162.18 | Professional | 52 · Reduced service | $31.62 | $31.62 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $64.57 | Professional | 53 · Discontinued | $12.59 | $12.59 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $48.98 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $32.36 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $32.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $7.08 Typical High $9.12 | Professional | RR · Rental | $7.08 | $7.08 | $9.12 |
Where Ohio sits
The same service costs 4.4 times more in Kansas than in Vermont. 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
$63.10
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.