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 $20.42 Median $20.42 Typical High $100.00 | Facility | None | $20.42 | $20.42 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $91.20 | Professional | None | $20.42 | $20.42 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $45.71 Typical High $83.18 | Facility | None | $36.31 | $45.71 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $20.89 Typical High $50.12 | Professional | None | $18.62 | $20.89 | $50.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.13 Median $15.49 Typical High $20.42 | Professional | UE · Used equipment | $14.13 | $15.49 | $20.42 |
CareSource Setting Facility Modifier None Typical Low $19.05 Median $28.84 Typical High $38.90 | Facility | None | $19.05 | $28.84 | $38.90 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $34.67 Typical High $52.48 | Professional | None | $25.12 | $34.67 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | None | $15.49 | $15.49 | $21.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | None | $15.49 | $15.49 | $21.38 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $33.11 Typical High $44.67 | Professional | None | $23.99 | $33.11 | $44.67 |
SummaCare Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $61.66 | Professional | None | $38.90 | $39.81 | $61.66 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $56.23 | Facility | None | $39.81 | $39.81 | $56.23 |
United Setting Professional Modifier None Typical Low $12.88 Median $18.62 Typical High $27.54 | Professional | None | $12.88 | $18.62 | $27.54 |
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 $10.23 Median $10.23 Typical High $45.71 | Professional | 52 · Reduced service | $10.23 | $10.23 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $18.20 | Professional | 53 · Discontinued | $4.07 | $4.07 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $13.80 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $9.12 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $9.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.04 Median $2.04 Typical High $2.24 | Professional | RR · Rental | $2.04 | $2.04 | $2.24 |
Where Ohio sits
The same service costs 3.1 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· 35th of 51
$20.42
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.