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 $40.74 Median $40.74 Typical High $141.25 | Facility | None | $40.74 | $40.74 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $131.83 | Professional | None | $40.74 | $40.74 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $89.13 Typical High $165.96 | Facility | None | $72.44 | $89.13 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $97.72 | Professional | None | $37.15 | $45.71 | $97.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $30.90 Typical High $42.66 | Professional | UE · Used equipment | $27.54 | $30.90 | $42.66 |
Aultcare Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | None | $66.07 | $66.07 | $69.18 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $64.57 Typical High $87.10 | Facility | None | $43.65 | $64.57 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $117.49 | Professional | None | $56.23 | $77.62 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $60.26 | Professional | None | $32.36 | $44.67 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $123.03 | Professional | None | $77.62 | $77.62 | $123.03 |
United Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $102.33 | Facility | None | $50.12 | $64.57 | $102.33 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $54.95 | Professional | None | $25.12 | $38.02 | $54.95 |
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 $20.42 Median $20.42 Typical High $66.07 | Professional | 52 · Reduced service | $20.42 | $20.42 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $26.30 | Professional | 53 · Discontinued | $8.13 | $8.13 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $19.95 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $13.18 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $13.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $5.89 | Professional | RR · Rental | $4.57 | $4.57 | $5.89 |
Where Ohio sits
The same service costs 4.7 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· 48th of 51
$40.74
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.