How much rates vary
Facilitymedian $20 · 10th to 90th $14 to $39Professionalmedian $10 · 10th to 90th $9 to $22
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 $9.33 Median $9.33 Typical High $52.48 | Facility | None | $9.33 | $9.33 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $52.48 | Professional | None | $9.33 | $9.33 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $15.85 | Professional | None | $11.22 | $11.22 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.20 Median $22.39 Typical High $40.74 | Facility | None | $18.20 | $22.39 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $11.75 Typical High $24.55 | Professional | None | $9.12 | $11.75 | $24.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6.92 Median $10.23 Typical High $14.13 | Professional | UE · Used equipment | $6.92 | $10.23 | $14.13 |
Aultcare Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
CareSource Setting Facility Modifier None Typical Low $11.48 Median $16.98 Typical High $22.91 | Facility | None | $11.48 | $16.98 | $22.91 |
CareSource Setting Professional Modifier None Typical Low $14.79 Median $20.42 Typical High $30.90 | Professional | None | $14.79 | $20.42 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Molina Setting Professional Modifier None Typical Low $7.94 Median $10.96 Typical High $14.79 | Professional | None | $7.94 | $10.96 | $14.79 |
SummaCare Setting Professional Modifier None Typical Low $19.05 Median $19.50 Typical High $30.20 | Professional | None | $19.05 | $19.50 | $30.20 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $25.70 | Facility | None | $12.59 | $12.88 | $25.70 |
United Setting Professional Modifier None Typical Low $6.31 Median $9.33 Typical High $14.45 | Professional | None | $6.31 | $9.33 | $14.45 |
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 $4.57 Median $4.57 Typical High $22.91 | Professional | 52 · Reduced service | $4.57 | $4.57 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $1.86 Typical High $9.12 | Professional | 53 · Discontinued | $1.86 | $1.86 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.38 Typical High $6.92 | Professional | 55 · Aftercare only | $1.38 | $1.38 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.91 Typical High $4.57 | Professional | 56 · Pre-op care only | $0.91 | $0.91 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.35 Median $1.35 Typical High $1.48 | Professional | RR · Rental | $1.35 | $1.35 | $1.48 |
Where Ohio sits
The same service costs 3.0 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· 50th of 51
$10.47
HI $31.62DE $10.47
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.