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 $100.00 Median $100.00 Typical High $346.74 | Facility | None | $100.00 | $100.00 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $323.59 | Professional | None | $100.00 | $100.00 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $407.38 | Facility | None | $181.97 | $223.87 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $204.17 | Professional | None | $91.20 | $107.15 | $204.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $77.62 Typical High $102.33 | Professional | UE · Used equipment | $69.18 | $77.62 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $151.36 Typical High $199.53 | Facility | None | $100.00 | $151.36 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $269.15 | Professional | None | $131.83 | $181.97 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $177.83 | Professional | None | $95.50 | $131.83 | $177.83 |
SummaCare Setting Professional Modifier None Typical Low $190.55 Median $194.98 Typical High $302.00 | Professional | None | $190.55 | $194.98 | $302.00 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $239.88 | Facility | None | $87.10 | $100.00 | $239.88 |
United Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $134.90 | Professional | None | $63.10 | $91.20 | $134.90 |
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 $50.12 Median $50.12 Typical High $162.18 | Professional | 52 · Reduced service | $50.12 | $50.12 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $64.57 | Professional | 53 · Discontinued | $20.42 | $20.42 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $48.98 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $32.36 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $32.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $14.13 | Professional | RR · Rental | $10.72 | $10.72 | $14.13 |
Where Ohio sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$107
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.