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 $223.87 | Facility | None | $38.02 | $38.02 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $154.88 | Professional | None | $38.02 | $38.02 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $169.82 | Facility | None | $74.13 | $93.33 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $89.13 | Professional | None | $38.90 | $53.70 | $89.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $33.88 Typical High $44.67 | Professional | UE · Used equipment | $29.51 | $33.88 | $44.67 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $67.61 Typical High $89.13 | Facility | None | $44.67 | $67.61 | $89.13 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $120.23 | Professional | None | $58.88 | $81.28 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
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 $19.95 Median $39.81 Typical High $107.15 | Facility | None | $19.95 | $39.81 | $107.15 |
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 $77.62 | Professional | 52 · Reduced service | $19.05 | $19.05 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $30.90 | Professional | 53 · Discontinued | $7.59 | $7.59 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $22.91 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $15.49 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $15.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $5.75 | Professional | RR · Rental | $5.37 | $5.37 | $5.75 |
Where Ohio sits
The same service costs 2.8 times more in Montana than in New Jersey. 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
$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.