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 $83.18 Median $83.18 Typical High $218.78 | Facility | None | $83.18 | $83.18 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $204.17 | Professional | None | $83.18 | $83.18 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $186.21 Typical High $338.84 | Facility | None | $147.91 | $186.21 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $199.53 | Professional | None | $74.13 | $83.18 | $199.53 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $57.54 Median $63.10 Typical High $81.28 | Professional | UE · Used equipment | $57.54 | $63.10 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $102.33 Typical High $138.04 | Facility | None | $69.18 | $102.33 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $186.21 | Professional | None | $89.13 | $123.03 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $123.03 | Professional | None | $66.07 | $91.20 | $123.03 |
SummaCare Setting Professional Modifier None Typical Low $158.49 Median $162.18 Typical High $251.19 | Professional | None | $158.49 | $162.18 | $251.19 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $186.21 | Facility | None | $39.81 | $69.18 | $186.21 |
United Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $112.20 | Professional | None | $51.29 | $74.13 | $112.20 |
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 $41.69 Median $41.69 Typical High $100.00 | Professional | 52 · Reduced service | $41.69 | $41.69 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $40.74 | Professional | 53 · Discontinued | $16.60 | $16.60 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $30.20 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $20.42 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $20.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.32 Median $8.32 Typical High $9.12 | Professional | RR · Rental | $8.32 | $8.32 | $9.12 |
Where Ohio sits
The same service costs 2.5 times more in Arkansas than in Florida. 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· 37th of 51
$83.18
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.