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 $15.14 Median $15.14 Typical High $117.49 | Facility | None | $15.14 | $15.14 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $109.65 | Professional | None | $15.14 | $15.14 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $67.61 | Professional | None | $33.88 | $39.81 | $67.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $29.51 Typical High $51.29 | Professional | UE · Used equipment | $26.30 | $29.51 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $114.82 Typical High $173.78 | Facility | None | $67.61 | $114.82 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $104.71 | Professional | None | $64.57 | $70.79 | $104.71 |
United Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $29.51 | Professional | None | $12.02 | $18.20 | $29.51 |
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 $7.59 Median $7.59 Typical High $54.95 | Professional | 52 · Reduced service | $7.59 | $7.59 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $21.88 | Professional | 53 · Discontinued | $3.02 | $3.02 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $16.22 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $10.96 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $10.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | RR · Rental | $6.76 | $6.76 | $6.76 |
Where Ohio sits
The same service costs 8.9 times more in North Dakota 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· 25th of 51
$36.31
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.