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 $26.30 Median $26.30 Typical High $87.10 | Facility | None | $26.30 | $26.30 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $81.28 | Professional | None | $26.30 | $26.30 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $57.54 Typical High $107.15 | Facility | None | $46.77 | $57.54 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $63.10 | Professional | None | $23.99 | $26.92 | $63.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17.78 Median $19.95 Typical High $26.92 | Professional | UE · Used equipment | $17.78 | $19.95 | $26.92 |
CareSource Setting Facility Modifier None Typical Low $24.55 Median $37.15 Typical High $48.98 | Facility | None | $24.55 | $37.15 | $48.98 |
CareSource Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $66.07 | Professional | None | $32.36 | $44.67 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Molina Setting Professional Modifier None Typical Low $12.30 Median $16.98 Typical High $22.91 | Professional | None | $12.30 | $16.98 | $22.91 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $79.43 | Professional | None | $50.12 | $51.29 | $79.43 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $70.79 | Facility | None | $50.12 | $50.12 | $70.79 |
United Setting Professional Modifier None Typical Low $16.22 Median $23.44 Typical High $35.48 | Professional | None | $16.22 | $23.44 | $35.48 |
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 $13.18 Median $13.18 Typical High $40.74 | Professional | 52 · Reduced service | $13.18 | $13.18 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $16.22 | Professional | 53 · Discontinued | $5.25 | $5.25 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $12.02 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $8.13 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $8.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $3.47 | Professional | RR · Rental | $2.69 | $2.69 | $3.47 |
Where Ohio sits
The same service costs 2.6 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· 36th of 51
$26.30
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.