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 $134.90 | Facility | None | $40.74 | $40.74 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $125.89 | Professional | None | $40.74 | $40.74 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $89.13 Typical High $162.18 | Facility | None | $72.44 | $89.13 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $40.74 Typical High $97.72 | Professional | None | $33.11 | $40.74 | $97.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $30.20 Typical High $39.81 | Professional | UE · Used equipment | $27.54 | $30.20 | $39.81 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $56.23 Typical High $75.86 | Facility | None | $38.02 | $56.23 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $102.33 | Professional | None | $48.98 | $67.61 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $40.74 Typical High $54.95 | Professional | None | $29.51 | $40.74 | $54.95 |
SummaCare Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $120.23 | Professional | None | $75.86 | $77.62 | $120.23 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $109.65 | Facility | None | $77.62 | $77.62 | $109.65 |
United Setting Professional Modifier None Typical Low $25.12 Median $36.31 Typical High $53.70 | Professional | None | $25.12 | $36.31 | $53.70 |
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 $19.95 Median $19.95 Typical High $63.10 | Professional | 52 · Reduced service | $19.95 | $19.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $25.12 | Professional | 53 · Discontinued | $8.13 | $8.13 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $19.05 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $12.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $4.47 | Professional | RR · Rental | $4.07 | $4.07 | $4.47 |
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· 33rd of 51
$40.74
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.