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 $17.78 Median $17.78 Typical High $42.66 | Facility | None | $17.78 | $17.78 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $39.81 | Professional | None | $17.78 | $17.78 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $66.07 | Professional | None | $34.67 | $40.74 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $28.84 Typical High $48.98 | Professional | UE · Used equipment | $26.30 | $28.84 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $151.36 Typical High $169.82 | Facility | None | $100.00 | $151.36 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $181.97 | Professional | None | $131.83 | $131.83 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $10.72 | Professional | None | $7.76 | $7.76 | $10.72 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $10.72 | Professional | None | $7.76 | $7.76 | $10.72 |
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 $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
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 $8.91 Median $8.91 Typical High $19.95 | Professional | 52 · Reduced service | $8.91 | $8.91 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $7.94 | Professional | 53 · Discontinued | $3.55 | $3.55 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $6.03 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $3.98 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $3.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | RR · Rental | $6.61 | $6.61 | $6.61 |
Where Ohio sits
The same service costs 27.5 times more in Kansas than in South Carolina. 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· 15th of 51
$35.48
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.