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 $69.18 Median $190.55 Typical High $234.42 | Facility | None | $69.18 | $190.55 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $208.93 | Professional | None | $69.18 | $69.18 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $281.84 | Facility | None | $123.03 | $151.36 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $165.96 | Professional | None | $63.10 | $75.86 | $165.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $53.70 Typical High $69.18 | Professional | UE · Used equipment | $46.77 | $53.70 | $69.18 |
Aultcare Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $141.25 | Facility | None | $70.79 | $104.71 | $141.25 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $190.55 | Professional | None | $91.20 | $125.89 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | None | $77.62 | $77.62 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | None | $77.62 | $77.62 | $100.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $151.36 | Professional | None | $81.28 | $112.20 | $151.36 |
SummaCare Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $208.93 | Professional | None | $131.83 | $134.90 | $208.93 |
United Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $165.96 | Facility | None | $60.26 | $81.28 | $165.96 |
United Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $93.33 | Professional | None | $42.66 | $61.66 | $93.33 |
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 $34.67 Median $34.67 Typical High $104.71 | Professional | 52 · Reduced service | $34.67 | $34.67 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $41.69 | Professional | 53 · Discontinued | $13.80 | $13.80 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $31.62 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $20.89 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $7.41 Typical High $7.94 | Professional | RR · Rental | $7.41 | $7.41 | $7.94 |
Where Ohio sits
The same service costs 3.1 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· 43rd of 51
$69.18
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.