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 $33.11 Median $91.20 Typical High $112.20 | Facility | None | $33.11 | $91.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $104.71 | Professional | None | $33.11 | $33.11 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $74.13 Typical High $134.90 | Facility | None | $58.88 | $74.13 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $69.18 | Professional | None | $30.20 | $34.67 | $69.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $26.30 Typical High $33.88 | Professional | UE · Used equipment | $22.91 | $26.30 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $28.84 Median $43.65 Typical High $58.88 | Facility | None | $28.84 | $43.65 | $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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $36.31 Typical High $48.98 | Professional | None | $26.30 | $36.31 | $48.98 |
SummaCare Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $100.00 | Professional | None | $63.10 | $64.57 | $100.00 |
United Setting Facility Modifier None Typical Low $35.48 Median $38.02 Typical High $79.43 | Facility | None | $35.48 | $38.02 | $79.43 |
United Setting Professional Modifier None Typical Low $20.89 Median $30.20 Typical High $44.67 | Professional | None | $20.89 | $30.20 | $44.67 |
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 $16.60 Median $16.60 Typical High $52.48 | Professional | 52 · Reduced service | $16.60 | $16.60 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $20.89 | Professional | 53 · Discontinued | $6.61 | $6.61 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $15.85 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $10.47 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $10.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $3.80 | Professional | RR · Rental | $3.47 | $3.47 | $3.80 |
Where Ohio sits
The same service costs 3.0 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· 39th of 51
$34.67
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.