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 $17.38 Median $17.38 Typical High $97.72 | Facility | None | $17.38 | $17.38 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $91.20 | Professional | None | $17.38 | $17.38 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $38.02 Typical High $53.70 | Professional | None | $33.11 | $38.02 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $50.12 | Professional | RR · Rental | $5.01 | $5.01 | $50.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.70 Median $29.51 Typical High $39.81 | Professional | UE · Used equipment | $25.70 | $29.51 | $39.81 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $91.20 Typical High $141.25 | Facility | None | $53.70 | $91.20 | $141.25 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $91.20 | Professional | None | $54.95 | $60.26 | $91.20 |
United Setting Professional Modifier None Typical Low $13.80 Median $20.89 Typical High $33.88 | Professional | None | $13.80 | $20.89 | $33.88 |
4 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 $8.71 Median $8.71 Typical High $45.71 | Professional | 52 · Reduced service | $8.71 | $8.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $18.20 | Professional | 53 · Discontinued | $3.47 | $3.47 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $13.80 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $9.12 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $9.12 |
Where Ohio sits
The same service costs 6.5 times more in Kansas 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
$33.88
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.