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 $12.02 Median $12.02 Typical High $64.57 | Facility | None | $12.02 | $12.02 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $53.70 | Professional | None | $12.02 | $12.02 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $29.51 Typical High $53.70 | Facility | None | $23.99 | $29.51 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $15.49 Typical High $32.36 | Professional | None | $12.59 | $15.49 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.33 Median $10.96 Typical High $14.45 | Professional | UE · Used equipment | $9.33 | $10.96 | $14.45 |
CareSource Setting Facility Modifier None Typical Low $12.88 Median $19.50 Typical High $25.70 | Facility | None | $12.88 | $19.50 | $25.70 |
CareSource Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $34.67 | Professional | None | $16.98 | $23.44 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Molina Setting Professional Modifier None Typical Low $10.47 Median $14.45 Typical High $19.50 | Professional | None | $10.47 | $14.45 | $19.50 |
SummaCare Setting Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $39.81 | Professional | None | $25.12 | $25.70 | $39.81 |
United Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $33.88 | Facility | None | $12.88 | $16.22 | $33.88 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.30 Typical High $19.05 | Professional | None | $8.32 | $12.30 | $19.05 |
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 $6.03 Median $6.03 Typical High $25.70 | Professional | 52 · Reduced service | $6.03 | $6.03 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $10.47 | Professional | 53 · Discontinued | $2.45 | $2.45 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $7.76 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $5.25 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $5.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.55 Median $1.55 Typical High $1.66 | Professional | RR · Rental | $1.55 | $1.55 | $1.66 |
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· 47th of 51
$13.80
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.