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 $30.20 Median $83.18 Typical High $102.33 | Facility | None | $30.20 | $83.18 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $95.50 | Professional | None | $30.20 | $30.20 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $67.61 Typical High $123.03 | Facility | None | $53.70 | $67.61 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $30.90 Typical High $74.13 | Professional | None | $27.54 | $30.90 | $74.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.89 Median $22.91 Typical High $30.20 | Professional | UE · Used equipment | $20.89 | $22.91 | $30.20 |
Aultcare Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $28.18 Median $42.66 Typical High $57.54 | Facility | None | $28.18 | $42.66 | $57.54 |
CareSource Setting Professional Modifier None Typical Low $37.15 Median $51.29 Typical High $77.62 | Professional | None | $37.15 | $51.29 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $34.67 | Facility | None | $33.11 | $33.11 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | None | $23.99 | $23.99 | $33.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $34.67 | Facility | None | $33.11 | $33.11 | $34.67 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | None | $23.99 | $23.99 | $33.11 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $14.13 Typical High $19.05 | Professional | None | $10.23 | $14.13 | $19.05 |
SummaCare Setting Professional Modifier None Typical Low $57.54 Median $58.88 Typical High $91.20 | Professional | None | $57.54 | $58.88 | $91.20 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $83.18 | Facility | None | $58.88 | $58.88 | $83.18 |
United Setting Professional Modifier None Typical Low $19.05 Median $27.54 Typical High $40.74 | Professional | None | $19.05 | $27.54 | $40.74 |
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 $15.14 Median $15.14 Typical High $47.86 | Professional | 52 · Reduced service | $15.14 | $15.14 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $19.05 | Professional | 53 · Discontinued | $6.03 | $6.03 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $14.45 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $9.55 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $9.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $3.31 | Professional | RR · Rental | $3.09 | $3.09 | $3.31 |
Where Ohio sits
The same service costs 2.6 times more in Montana than in Kansas. 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· 41st of 51
$30.20
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.