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 $50.12 Median $138.04 Typical High $204.17 | Facility | None | $50.12 | $138.04 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $204.17 | Professional | None | $50.12 | $50.12 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $109.65 Typical High $204.17 | Facility | None | $89.13 | $109.65 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $120.23 | Professional | None | $44.67 | $51.29 | $120.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $37.15 Typical High $48.98 | Professional | UE · Used equipment | $33.88 | $37.15 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $46.77 Median $70.79 Typical High $93.33 | Facility | None | $46.77 | $70.79 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $125.89 | Professional | None | $60.26 | $85.11 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Facility | None | $56.23 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Facility | None | $56.23 | $56.23 | $64.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $93.33 | Professional | None | $50.12 | $69.18 | $93.33 |
SummaCare Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $151.36 | Professional | None | $95.50 | $95.50 | $151.36 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $112.20 | Facility | None | $44.67 | $44.67 | $112.20 |
United Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $67.61 | Professional | None | $30.90 | $44.67 | $67.61 |
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 $25.12 Median $25.12 Typical High $100.00 | Professional | 52 · Reduced service | $25.12 | $25.12 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $40.74 | Professional | 53 · Discontinued | $10.00 | $10.00 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $30.20 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $20.42 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $20.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $6.61 | Professional | RR · Rental | $4.90 | $4.90 | $6.61 |
Where Ohio sits
The same service costs 2.6 times more in Kansas 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
$50.12
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.