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 $6.17 Median $8.13 Typical High $40.74 | Facility | None | $6.17 | $8.13 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $40.74 | Professional | None | $6.17 | $6.17 | $40.74 |
Ambetter Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $14.45 Typical High $21.88 | Professional | None | $14.13 | $14.45 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.72 Median $10.72 Typical High $15.85 | Professional | UE · Used equipment | $10.72 | $10.72 | $15.85 |
Aultcare Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
CareSource Setting Facility Modifier None Typical Low $10.96 Median $14.79 Typical High $25.12 | Facility | None | $10.96 | $14.79 | $25.12 |
CareSource Setting Professional Modifier None Typical Low $12.88 Median $14.79 Typical High $17.38 | Professional | None | $12.88 | $14.79 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $22.39 | Facility | None | $20.89 | $20.89 | $22.39 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $12.59 Median $15.49 Typical High $23.99 | Professional | None | $12.59 | $15.49 | $23.99 |
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 $4.90 Median $7.41 Typical High $11.75 | Professional | None | $4.90 | $7.41 | $11.75 |
6 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 $3.09 Median $3.09 Typical High $20.42 | Professional | 52 · Reduced service | $3.09 | $3.09 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $8.13 | Professional | 53 · Discontinued | $1.23 | $1.23 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.93 Median $0.93 Typical High $6.17 | Professional | 55 · Aftercare only | $0.93 | $0.93 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $4.07 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $4.07 |
Ambetter Setting Professional Modifier GY · Excluded by law Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | GY · Excluded by law | $7.24 | $7.24 | $7.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.41 Median $1.41 Typical High $1.45 | Professional | RR · Rental | $1.41 | $1.41 | $1.45 |
Where Ohio sits
The same service costs 6.2 times more in Wyoming than in North 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· 29th of 51
$14.13
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.