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 $25.12 Median $25.12 Typical High $151.36 | Facility | None | $25.12 | $25.12 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $141.25 | Professional | None | $25.12 | $25.12 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $77.62 | Professional | None | $50.12 | $50.12 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $53.70 | Professional | UE · Used equipment | $37.15 | $37.15 | $53.70 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $67.61 Typical High $77.62 | Facility | None | $45.71 | $67.61 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $60.26 | Professional | None | $30.20 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $19.95 Median $30.20 Typical High $48.98 | Professional | None | $19.95 | $30.20 | $48.98 |
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 $12.59 Median $12.59 Typical High $70.79 | Professional | 52 · Reduced service | $12.59 | $12.59 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $28.18 | Professional | 53 · Discontinued | $5.13 | $5.13 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $21.38 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $14.13 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | RR · Rental | $5.01 | $5.01 | $5.01 |
Where Ohio sits
The same service costs 4.1 times more in Kansas than in Colorado. 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· 12th of 51
$50.12
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.