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 $28.18 Median $77.62 Typical High $97.72 | Facility | None | $28.18 | $77.62 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $97.72 | Professional | None | $28.18 | $28.18 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $114.82 | Facility | None | $50.12 | $61.66 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $27.54 Typical High $67.61 | Professional | None | $25.70 | $27.54 | $67.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.05 Median $20.42 Typical High $27.54 | Professional | UE · Used equipment | $19.05 | $20.42 | $27.54 |
Aultcare Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
CareSource Setting Facility Modifier None Typical Low $26.30 Median $38.90 Typical High $52.48 | Facility | None | $26.30 | $38.90 | $52.48 |
CareSource Setting Professional Modifier None Typical Low $33.88 Median $46.77 Typical High $70.79 | Professional | None | $33.88 | $46.77 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $36.31 | Facility | None | $34.67 | $34.67 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $36.31 | Facility | None | $34.67 | $34.67 | $36.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $28.18 Typical High $38.02 | Professional | None | $20.42 | $28.18 | $38.02 |
SummaCare Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $83.18 | Professional | None | $53.70 | $56.23 | $83.18 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $75.86 | Facility | None | $53.70 | $53.70 | $75.86 |
United Setting Professional Modifier None Typical Low $17.38 Median $25.12 Typical High $38.02 | Professional | None | $17.38 | $25.12 | $38.02 |
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 $14.13 Median $14.13 Typical High $48.98 | Professional | 52 · Reduced service | $14.13 | $14.13 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $19.50 | Professional | 53 · Discontinued | $5.62 | $5.62 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $14.45 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $9.77 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $9.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $2.95 | Professional | RR · Rental | $2.75 | $2.75 | $2.95 |
Where Ohio sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 38th of 51
$27.54
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.