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 $38.02 Median $38.02 Typical High $204.17 | Facility | None | $38.02 | $38.02 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $141.25 | Professional | None | $38.02 | $38.02 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $91.20 Typical High $169.82 | Facility | None | $74.13 | $91.20 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $87.10 | Professional | None | $38.02 | $51.29 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.18 Median $31.62 Typical High $41.69 | Professional | UE · Used equipment | $28.18 | $31.62 | $41.69 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $64.57 Typical High $85.11 | Facility | None | $42.66 | $64.57 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $114.82 | Professional | None | $54.95 | $75.86 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $61.66 | Professional | None | $33.11 | $45.71 | $61.66 |
SummaCare Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $125.89 | Professional | None | $79.43 | $81.28 | $125.89 |
United Setting Facility Modifier None Typical Low $32.36 Median $38.90 Typical High $104.71 | Facility | None | $32.36 | $38.90 | $104.71 |
United Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $60.26 | Professional | None | $25.70 | $38.90 | $60.26 |
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 $19.05 Median $19.05 Typical High $70.79 | Professional | 52 · Reduced service | $19.05 | $19.05 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $28.18 | Professional | 53 · Discontinued | $7.59 | $7.59 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $20.89 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $14.13 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.13 Median $5.13 Typical High $5.50 | Professional | RR · Rental | $5.13 | $5.13 | $5.50 |
Where Ohio sits
The same service costs 2.1 times more in Arkansas than in Colorado. 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· 45th of 51
$46.77
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.