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 $46.77 Median $46.77 Typical High $245.47 | Facility | None | $46.77 | $46.77 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $169.82 | Professional | None | $46.77 | $46.77 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $97.72 Typical High $154.88 | Facility | None | $85.11 | $97.72 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $112.20 | Professional | None | $53.70 | $66.07 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $67.61 Typical High $91.20 | Facility | None | $44.67 | $67.61 | $91.20 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $112.20 Typical High $123.03 | Professional | None | $58.88 | $112.20 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $93.33 | Professional | None | $50.12 | $63.10 | $93.33 |
SummaCare Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $134.90 | Professional | None | $93.33 | $109.65 | $134.90 |
United Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $74.13 | Professional | None | $30.20 | $50.12 | $74.13 |
8 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 $23.44 Median $23.44 Typical High $85.11 | Professional | 52 · Reduced service | $23.44 | $23.44 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $33.88 | Professional | 53 · Discontinued | $9.55 | $9.55 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $25.70 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $16.98 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $16.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $6.46 | Professional | RR · Rental | $5.37 | $5.37 | $6.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $47.86 Typical High $69.18 | Professional | UE · Used equipment | $39.81 | $47.86 | $69.18 |
Cigna Setting Facility Modifier RR · Rental Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | RR · Rental | $64.57 | $64.57 | $64.57 |
Medical Mutual of Ohio Setting Facility Modifier RR · Rental Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | RR · Rental | $64.57 | $64.57 | $64.57 |
Where Ohio sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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· 25th of 51
$63.10
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.