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 $61.66 Median $61.66 Typical High $208.93 | Facility | None | $61.66 | $61.66 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $194.98 | Professional | None | $61.66 | $61.66 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $138.04 Typical High $251.19 | Facility | None | $109.65 | $138.04 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $154.88 | Professional | None | $54.95 | $67.61 | $154.88 |
Aultcare Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $87.10 Typical High $117.49 | Facility | None | $58.88 | $87.10 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $158.49 | Professional | None | $75.86 | $104.71 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $147.91 | Professional | None | $79.43 | $109.65 | $147.91 |
SummaCare Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $186.21 | Professional | None | $117.49 | $123.03 | $186.21 |
United Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $141.25 | Facility | None | $57.54 | $63.10 | $141.25 |
United Setting Professional Modifier None Typical Low $38.90 Median $56.23 Typical High $83.18 | Professional | None | $38.90 | $56.23 | $83.18 |
6 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 $30.90 Median $30.90 Typical High $97.72 | Professional | 52 · Reduced service | $30.90 | $30.90 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $28.84 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $19.50 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $19.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $7.24 | Professional | RR · Rental | $6.61 | $6.61 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $61.66 | Professional | UE · Used equipment | $50.12 | $50.12 | $61.66 |
Where Ohio sits
The same service costs 2.4 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· 38th of 51
$61.66
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.