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 $13.80 Median $13.80 Typical High $70.79 | Facility | None | $13.80 | $13.80 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $70.79 | Professional | None | $13.80 | $13.80 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $27.54 Median $33.88 Typical High $61.66 | Facility | None | $27.54 | $33.88 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $17.38 Typical High $37.15 | Professional | None | $13.80 | $17.38 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.47 Median $12.02 Typical High $15.85 | Professional | UE · Used equipment | $10.47 | $12.02 | $15.85 |
Aultcare Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
CareSource Setting Facility Modifier None Typical Low $16.60 Median $24.55 Typical High $33.11 | Facility | None | $16.60 | $24.55 | $33.11 |
CareSource Setting Professional Modifier None Typical Low $21.38 Median $29.51 Typical High $44.67 | Professional | None | $21.38 | $29.51 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
Molina Setting Professional Modifier None Typical Low $12.02 Median $16.60 Typical High $22.39 | Professional | None | $12.02 | $16.60 | $22.39 |
SummaCare Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $45.71 | Professional | None | $28.84 | $29.51 | $45.71 |
United Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $36.31 | Facility | None | $14.45 | $16.60 | $36.31 |
United Setting Professional Modifier None Typical Low $9.55 Median $14.13 Typical High $20.42 | Professional | None | $9.55 | $14.13 | $20.42 |
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 $6.92 Median $6.92 Typical High $33.11 | Professional | 52 · Reduced service | $6.92 | $6.92 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $13.18 | Professional | 53 · Discontinued | $2.82 | $2.82 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $10.00 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $6.61 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $6.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.00 Median $2.00 Typical High $2.09 | Professional | RR · Rental | $2.00 | $2.00 | $2.09 |
Where Ohio sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 43rd of 51
$15.85
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.