How much rates vary
Facilitymedian $27 · 10th to 90th $16 to $45Professionalmedian $13 · 10th to 90th $12 to $27
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 $12.30 Median $12.30 Typical High $60.26 | Facility | None | $12.30 | $12.30 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $60.26 | Professional | None | $12.30 | $12.30 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $29.51 Typical High $54.95 | Facility | None | $23.99 | $29.51 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.30 Median $15.49 Typical High $32.36 | Professional | None | $12.30 | $15.49 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.12 Median $10.72 Typical High $14.13 | Professional | UE · Used equipment | $9.12 | $10.72 | $14.13 |
Aultcare Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
CareSource Setting Facility Modifier None Typical Low $15.14 Median $22.39 Typical High $30.20 | Facility | None | $15.14 | $22.39 | $30.20 |
CareSource Setting Professional Modifier None Typical Low $19.50 Median $26.92 Typical High $40.74 | Professional | None | $19.50 | $26.92 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Molina Setting Professional Modifier None Typical Low $10.72 Median $14.79 Typical High $19.95 | Professional | None | $10.72 | $14.79 | $19.95 |
SummaCare Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $40.74 | Professional | None | $25.70 | $26.30 | $40.74 |
United Setting Facility Modifier None Typical Low $12.88 Median $15.49 Typical High $31.62 | Facility | None | $12.88 | $15.49 | $31.62 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $18.20 | Professional | None | $8.32 | $12.59 | $18.20 |
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 $6.17 Median $6.17 Typical High $20.89 | Professional | 52 · Reduced service | $6.17 | $6.17 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $8.32 | Professional | 53 · Discontinued | $2.45 | $2.45 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $6.31 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $4.17 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $4.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $1.86 | Professional | RR · Rental | $1.82 | $1.82 | $1.86 |
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· 42nd of 51
$14.13
HI $35.48DE $12.02
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.