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 $26.92 Median $26.92 Typical High $114.82 | Facility | None | $26.92 | $26.92 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $107.15 | Professional | None | $26.92 | $26.92 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $60.26 Typical High $109.65 | Facility | None | $47.86 | $60.26 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $64.57 | Professional | None | $24.55 | $27.54 | $64.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.62 Median $20.42 Typical High $26.92 | Professional | UE · Used equipment | $18.62 | $20.42 | $26.92 |
CareSource Setting Facility Modifier None Typical Low $25.70 Median $38.02 Typical High $51.29 | Facility | None | $25.70 | $38.02 | $51.29 |
CareSource Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $69.18 | Professional | None | $33.11 | $45.71 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $47.86 | Professional | None | $25.70 | $35.48 | $47.86 |
SummaCare Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $81.28 | Professional | None | $51.29 | $52.48 | $81.28 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $74.13 | Facility | None | $52.48 | $52.48 | $74.13 |
United Setting Professional Modifier None Typical Low $16.98 Median $24.55 Typical High $36.31 | Professional | None | $16.98 | $24.55 | $36.31 |
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 $13.49 Median $13.49 Typical High $53.70 | Professional | 52 · Reduced service | $13.49 | $13.49 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $21.38 | Professional | 53 · Discontinued | $5.37 | $5.37 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $16.22 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $10.72 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $10.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $2.95 | Professional | RR · Rental | $2.75 | $2.75 | $2.95 |
Where Ohio sits
The same service costs 2.2 times more in Montana than in Arizona. 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· 39th of 51
$26.92
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.