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 $10.96 Median $10.96 Typical High $144.54 | Facility | None | $10.96 | $10.96 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $134.90 | Professional | None | $10.96 | $10.96 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $24.55 Typical High $54.95 | Professional | None | $20.42 | $24.55 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.85 Median $18.20 Typical High $40.74 | Professional | UE · Used equipment | $15.85 | $18.20 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $109.65 Typical High $169.82 | Facility | None | $64.57 | $109.65 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $117.49 | Professional | None | $83.18 | $83.18 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $229.09 | Professional | None | $138.04 | $151.36 | $229.09 |
United Setting Professional Modifier None Typical Low $8.51 Median $12.88 Typical High $20.89 | Professional | None | $8.51 | $12.88 | $20.89 |
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 $5.37 Median $5.37 Typical High $67.61 | Professional | 52 · Reduced service | $5.37 | $5.37 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $26.92 | Professional | 53 · Discontinued | $2.19 | $2.19 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.62 Typical High $20.42 | Professional | 55 · Aftercare only | $1.62 | $1.62 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $13.49 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $13.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | RR · Rental | $5.50 | $5.50 | $5.50 |
Where Ohio sits
The same service costs 8.7 times more in Hawaii than in Kansas. 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· 21st of 51
$21.38
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.