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 $19.05 Median $19.05 Typical High $70.79 | Facility | None | $19.05 | $19.05 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $64.57 | Professional | None | $19.05 | $19.05 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.88 Median $41.69 Typical High $77.62 | Facility | None | $33.88 | $41.69 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $45.71 | Professional | None | $17.38 | $18.62 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.88 Median $13.80 Typical High $18.62 | Professional | UE · Used equipment | $12.88 | $13.80 | $18.62 |
CareSource Setting Facility Modifier None Typical Low $17.78 Median $26.30 Typical High $35.48 | Facility | None | $17.78 | $26.30 | $35.48 |
CareSource Setting Professional Modifier None Typical Low $22.91 Median $31.62 Typical High $47.86 | Professional | None | $22.91 | $31.62 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Molina Setting Professional Modifier None Typical Low $9.33 Median $12.88 Typical High $17.38 | Professional | None | $9.33 | $12.88 | $17.38 |
SummaCare Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | None | $36.31 | $36.31 | $56.23 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $51.29 | Facility | None | $36.31 | $36.31 | $51.29 |
United Setting Professional Modifier None Typical Low $11.75 Median $16.98 Typical High $25.70 | Professional | None | $11.75 | $16.98 | $25.70 |
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 $9.55 Median $9.55 Typical High $32.36 | Professional | 52 · Reduced service | $9.55 | $9.55 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $12.88 | Professional | 53 · Discontinued | $3.80 | $3.80 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $9.77 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $6.46 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $6.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $18.62 | Professional | RR · Rental | $1.82 | $1.82 | $18.62 |
Where Ohio sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$18.62
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.