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 $43.65 Median $43.65 Typical High $128.82 | Facility | None | $43.65 | $43.65 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $120.23 | Professional | None | $43.65 | $43.65 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $177.83 | Facility | None | $77.62 | $95.50 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $91.20 | Professional | None | $39.81 | $39.81 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $4.27 Typical High $39.81 | Professional | RR · Rental | $3.98 | $4.27 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $42.66 | Professional | UE · Used equipment | $29.51 | $29.51 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $33.11 Median $50.12 Typical High $66.07 | Facility | None | $33.11 | $50.12 | $66.07 |
CareSource Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $89.13 | Professional | None | $42.66 | $60.26 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $64.57 | Professional | None | $34.67 | $47.86 | $64.57 |
SummaCare Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $131.83 | Professional | None | $83.18 | $85.11 | $131.83 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $89.13 | Facility | None | $43.65 | $43.65 | $89.13 |
United Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $58.88 | Professional | None | $25.70 | $38.90 | $58.88 |
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 $21.88 Median $21.88 Typical High $60.26 | Professional | 52 · Reduced service | $21.88 | $21.88 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $23.99 | Professional | 53 · Discontinued | $8.71 | $8.71 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $18.20 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $12.02 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $12.02 |
Where Ohio sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 39th of 51
$40.74
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.