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 $47.86 Median $47.86 Typical High $154.88 | Facility | None | $47.86 | $47.86 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $144.54 | Professional | None | $47.86 | $47.86 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $104.71 Typical High $194.98 | Facility | None | $85.11 | $104.71 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $97.72 | Professional | None | $43.65 | $46.77 | $97.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $32.36 Median $34.67 Typical High $46.77 | Professional | UE · Used equipment | $32.36 | $34.67 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $67.61 Typical High $89.13 | Facility | None | $44.67 | $67.61 | $89.13 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $120.23 | Professional | None | $57.54 | $81.28 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $38.02 Typical High $51.29 | Professional | None | $27.54 | $38.02 | $51.29 |
SummaCare Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $144.54 | Professional | None | $91.20 | $91.20 | $144.54 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $128.82 | Facility | None | $91.20 | $91.20 | $128.82 |
United Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $64.57 | Professional | None | $29.51 | $42.66 | $64.57 |
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 $23.99 Median $23.99 Typical High $72.44 | Professional | 52 · Reduced service | $23.99 | $23.99 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $28.84 | Professional | 53 · Discontinued | $9.55 | $9.55 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $21.88 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $14.45 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $14.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $4.68 Typical High $6.31 | Professional | RR · Rental | $4.68 | $4.68 | $6.31 |
Where Ohio sits
The same service costs 3.1 times more in Hawaii 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
$46.77
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.