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 $32.36 Median $32.36 Typical High $100.00 | Facility | None | $32.36 | $32.36 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $91.20 | Professional | None | $32.36 | $32.36 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $70.79 Typical High $131.83 | Facility | None | $57.54 | $70.79 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $77.62 | Professional | None | $28.84 | $31.62 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $21.88 Median $23.99 Typical High $31.62 | Professional | UE · Used equipment | $21.88 | $23.99 | $31.62 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $44.67 Typical High $60.26 | Facility | None | $30.20 | $44.67 | $60.26 |
CareSource Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $81.28 | Professional | None | $38.90 | $53.70 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $17.38 Typical High $23.44 | Professional | None | $12.59 | $17.38 | $23.44 |
SummaCare Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $95.50 | Professional | None | $61.66 | $61.66 | $95.50 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $87.10 | Facility | None | $61.66 | $61.66 | $87.10 |
United Setting Professional Modifier None Typical Low $19.95 Median $28.84 Typical High $43.65 | Professional | None | $19.95 | $28.84 | $43.65 |
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 $16.22 Median $16.22 Typical High $45.71 | Professional | 52 · Reduced service | $16.22 | $16.22 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $18.20 | Professional | 53 · Discontinued | $6.46 | $6.46 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $13.80 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $9.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.16 Median $3.16 Typical High $3.39 | Professional | RR · Rental | $3.16 | $3.16 | $3.39 |
Where Ohio sits
The same service costs 2.8 times more in Kansas 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· 38th of 51
$31.62
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.