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 $48.98 Median $87.10 Typical High $173.78 | Facility | None | $48.98 | $87.10 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $223.87 | Professional | None | $48.98 | $48.98 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $109.65 Typical High $199.53 | Facility | None | $87.10 | $109.65 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $102.33 | Professional | None | $44.67 | $48.98 | $102.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $37.15 Typical High $48.98 | Professional | UE · Used equipment | $33.88 | $37.15 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $69.18 Typical High $93.33 | Facility | None | $45.71 | $69.18 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $125.89 | Professional | None | $60.26 | $83.18 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $64.57 | Facility | None | $61.66 | $61.66 | $64.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $100.00 | Professional | None | $53.70 | $74.13 | $100.00 |
SummaCare Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $147.91 | Professional | None | $93.33 | $95.50 | $147.91 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $134.90 | Facility | None | $95.50 | $95.50 | $134.90 |
United Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $66.07 | Professional | None | $30.90 | $44.67 | $66.07 |
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 $24.55 Median $24.55 Typical High $112.20 | Professional | 52 · Reduced service | $24.55 | $24.55 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $44.67 | Professional | 53 · Discontinued | $9.77 | $9.77 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $33.88 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $22.39 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $6.46 | Professional | RR · Rental | $4.90 | $4.90 | $6.46 |
Where Ohio sits
The same service costs 2.3 times more in Kansas 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· 42nd of 51
$48.98
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.