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 $40.74 Median $40.74 Typical High $251.19 | Facility | None | $40.74 | $40.74 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $234.42 | Professional | None | $40.74 | $40.74 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $89.13 | Professional | None | $38.90 | $57.54 | $89.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $42.66 Typical High $61.66 | Professional | UE · Used equipment | $29.51 | $42.66 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $77.62 Typical High $117.49 | Facility | None | $45.71 | $77.62 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | None | $27.54 | $27.54 | $38.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | None | $27.54 | $27.54 | $38.02 |
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 $32.36 Median $48.98 Typical High $79.43 | Professional | None | $32.36 | $48.98 | $79.43 |
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 $20.42 Median $20.42 Typical High $117.49 | Professional | 52 · Reduced service | $20.42 | $20.42 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $46.77 | Professional | 53 · Discontinued | $8.13 | $8.13 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $35.48 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $23.44 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $23.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | RR · Rental | $3.89 | $3.89 | $3.89 |
Where Ohio sits
The same service costs 49.0 times more in North Dakota than in Hawaii. 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· 36th of 51
$48.98
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.