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 $22.39 Median $22.39 Typical High $85.11 | Facility | None | $22.39 | $22.39 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $79.43 | Professional | None | $22.39 | $22.39 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $48.98 Typical High $91.20 | Facility | None | $39.81 | $48.98 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $20.42 Typical High $53.70 | Professional | None | $13.18 | $20.42 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.00 Median $15.14 Typical High $22.39 | Professional | UE · Used equipment | $10.00 | $15.14 | $22.39 |
CareSource Setting Facility Modifier None Typical Low $20.89 Median $30.90 Typical High $41.69 | Facility | None | $20.89 | $30.90 | $41.69 |
CareSource Setting Professional Modifier None Typical Low $26.92 Median $37.15 Typical High $56.23 | Professional | None | $26.92 | $37.15 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Molina Setting Professional Modifier None Typical Low $11.22 Median $15.49 Typical High $20.89 | Professional | None | $11.22 | $15.49 | $20.89 |
SummaCare Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $66.07 | Professional | None | $42.66 | $42.66 | $66.07 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $60.26 | Facility | None | $42.66 | $42.66 | $60.26 |
United Setting Professional Modifier None Typical Low $13.80 Median $19.95 Typical High $30.20 | Professional | None | $13.80 | $19.95 | $30.20 |
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 $11.22 Median $11.22 Typical High $39.81 | Professional | 52 · Reduced service | $11.22 | $11.22 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $15.85 | Professional | 53 · Discontinued | $4.47 | $4.47 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $11.75 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $7.94 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $7.94 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.45 Median $2.95 Typical High $13.18 | Professional | RR · Rental | $1.45 | $2.95 | $13.18 |
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· 41st of 51
$20.42
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.