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 $24.55 Median $67.61 Typical High $83.18 | Facility | None | $24.55 | $67.61 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $74.13 | Professional | None | $24.55 | $24.55 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $54.95 Typical High $100.00 | Facility | None | $43.65 | $54.95 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $23.99 Typical High $51.29 | Professional | None | $22.39 | $23.99 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $16.98 Median $18.20 Typical High $24.55 | Professional | UE · Used equipment | $16.98 | $18.20 | $24.55 |
CareSource Setting Facility Modifier None Typical Low $22.91 Median $34.67 Typical High $45.71 | Facility | None | $22.91 | $34.67 | $45.71 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $41.69 Typical High $63.10 | Professional | None | $30.20 | $41.69 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $33.11 Typical High $44.67 | Professional | None | $23.99 | $33.11 | $44.67 |
SummaCare Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $74.13 | Professional | None | $46.77 | $47.86 | $74.13 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $67.61 | Facility | None | $47.86 | $47.86 | $67.61 |
United Setting Professional Modifier None Typical Low $15.14 Median $22.39 Typical High $33.11 | Professional | None | $15.14 | $22.39 | $33.11 |
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 $12.30 Median $12.30 Typical High $37.15 | Professional | 52 · Reduced service | $12.30 | $12.30 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $14.79 | Professional | 53 · Discontinued | $4.90 | $4.90 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $11.22 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $7.41 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $7.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.45 Median $2.45 Typical High $2.63 | Professional | RR · Rental | $2.45 | $2.45 | $2.63 |
Where Ohio sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 33rd of 51
$24.55
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.