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 $43.65 Median $43.65 Typical High $141.25 | Facility | None | $43.65 | $43.65 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $109.65 | Professional | None | $43.65 | $43.65 | $109.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $177.83 | Facility | None | $77.62 | $95.50 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $104.71 | Professional | None | $39.81 | $41.69 | $104.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $30.20 Typical High $40.74 | Professional | UE · Used equipment | $29.51 | $30.20 | $40.74 |
Aultcare Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $33.88 Median $51.29 Typical High $69.18 | Facility | None | $33.88 | $51.29 | $69.18 |
CareSource Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $93.33 | Professional | None | $44.67 | $61.66 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $64.57 | Professional | None | $34.67 | $47.86 | $64.57 |
SummaCare Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $131.83 | Professional | None | $83.18 | $85.11 | $131.83 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $91.20 | Facility | None | $38.90 | $38.90 | $91.20 |
United Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $58.88 | Professional | None | $25.70 | $38.90 | $58.88 |
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 $21.88 Median $21.88 Typical High $54.95 | Professional | 52 · Reduced service | $21.88 | $21.88 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $21.88 | Professional | 53 · Discontinued | $8.71 | $8.71 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $16.22 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $10.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $4.37 | Professional | RR · Rental | $4.07 | $4.07 | $4.37 |
Where Ohio sits
The same service costs 2.9 times more in Hawaii 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· 25th of 51
$41.69
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.