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 $33.88 Median $33.88 Typical High $125.89 | Facility | None | $33.88 | $33.88 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $117.49 | Professional | None | $33.88 | $33.88 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $74.13 Typical High $138.04 | Facility | None | $60.26 | $74.13 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $36.31 Typical High $81.28 | Professional | None | $27.54 | $36.31 | $81.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $25.12 Typical High $33.88 | Professional | UE · Used equipment | $22.91 | $25.12 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $60.26 Typical High $79.43 | Facility | None | $39.81 | $60.26 | $79.43 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $107.15 | Professional | None | $51.29 | $72.44 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $37.15 Typical High $50.12 | Professional | None | $26.92 | $37.15 | $50.12 |
SummaCare Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $102.33 | Professional | None | $64.57 | $64.57 | $102.33 |
United Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $85.11 | Facility | None | $36.31 | $40.74 | $85.11 |
United Setting Professional Modifier None Typical Low $20.89 Median $30.90 Typical High $46.77 | Professional | None | $20.89 | $30.90 | $46.77 |
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 $16.98 Median $16.98 Typical High $58.88 | Professional | 52 · Reduced service | $16.98 | $16.98 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $23.44 | Professional | 53 · Discontinued | $6.76 | $6.76 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $17.38 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $11.75 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $11.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.72 Median $3.72 Typical High $5.01 | Professional | RR · Rental | $3.72 | $3.72 | $5.01 |
Where Ohio sits
The same service costs 2.7 times more in Montana 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
$33.88
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.