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 $37.15 Median $37.15 Typical High $218.78 | Facility | None | $37.15 | $37.15 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $151.36 | Professional | None | $37.15 | $37.15 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $165.96 | Facility | None | $72.44 | $91.20 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $97.72 | Professional | None | $37.15 | $42.66 | $97.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.18 Median $30.90 Typical High $40.74 | Professional | UE · Used equipment | $28.18 | $30.90 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $57.54 Typical High $75.86 | Facility | None | $38.02 | $57.54 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $102.33 | Professional | None | $50.12 | $69.18 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $89.13 | Professional | None | $47.86 | $66.07 | $89.13 |
SummaCare Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $123.03 | Professional | None | $77.62 | $79.43 | $123.03 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $112.20 | Facility | None | $79.43 | $79.43 | $112.20 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $54.95 | Professional | None | $25.12 | $38.02 | $54.95 |
3 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 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $22.91 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $15.14 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $15.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.57 | Professional | RR · Rental | $4.27 | $4.27 | $4.57 |
Where Ohio sits
The same service costs 2.2 times more in Montana than in West Virginia. 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· 40th of 51
$41.69
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.