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 $6.03 Median $6.03 Typical High $218.78 | Facility | None | $6.03 | $6.03 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $204.17 | Professional | None | $6.03 | $6.03 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.91 Median $10.47 Typical High $125.89 | Professional | None | $8.91 | $10.47 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6.76 Median $8.13 Typical High $93.33 | Professional | UE · Used equipment | $6.76 | $8.13 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $181.97 Typical High $281.84 | Facility | None | $107.15 | $181.97 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $9.33 | Professional | None | $6.76 | $6.76 | $9.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $9.33 | Professional | None | $6.76 | $6.76 | $9.33 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $158.49 | Professional | None | $95.50 | $104.71 | $158.49 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.62 Typical High $9.55 | Professional | None | $3.72 | $5.62 | $9.55 |
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 $3.02 Median $3.02 Typical High $100.00 | Professional | 52 · Reduced service | $3.02 | $3.02 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $40.74 | Professional | 53 · Discontinued | $1.23 | $1.23 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $30.20 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $20.42 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $20.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | RR · Rental | $12.59 | $12.59 | $12.59 |
Where Ohio sits
The same service costs 39.8 times more in New York than in Hawaii. 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· 20th of 51
$8.91
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.