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 $151.36 | Facility | None | $26.92 | $26.92 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $104.71 | Professional | None | $26.92 | $26.92 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $66.07 Typical High $120.23 | Facility | None | $52.48 | $66.07 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $33.11 Typical High $63.10 | Professional | None | $27.54 | $33.11 | $63.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.89 Median $23.44 Typical High $30.20 | Professional | UE · Used equipment | $20.89 | $23.44 | $30.20 |
CareSource Setting Facility Modifier None Typical Low $27.54 Median $41.69 Typical High $54.95 | Facility | None | $27.54 | $41.69 | $54.95 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $74.13 | Professional | None | $36.31 | $50.12 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $32.36 Typical High $43.65 | Professional | None | $23.44 | $32.36 | $43.65 |
SummaCare Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $89.13 | Professional | None | $56.23 | $57.54 | $89.13 |
United Setting Facility Modifier None Typical Low $27.54 Median $29.51 Typical High $75.86 | Facility | None | $27.54 | $29.51 | $75.86 |
United Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $42.66 | Professional | None | $18.20 | $27.54 | $42.66 |
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 $52.48 | Professional | 52 · Reduced service | $13.49 | $13.49 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $20.89 | Professional | 53 · Discontinued | $5.37 | $5.37 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $15.49 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $10.47 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $10.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $3.63 | Professional | RR · Rental | $3.31 | $3.31 | $3.63 |
Where Ohio sits
The same service costs 2.5 times more in Hawaii 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· 37th of 51
$33.11
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.