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 $97.72 Median $97.72 Typical High $562.34 | Facility | None | $97.72 | $97.72 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $524.81 | Professional | None | $97.72 | $97.72 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $407.38 | Facility | None | $177.83 | $218.78 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $275.42 | Professional | None | $162.18 | $194.98 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $162.18 Typical High $218.78 | Facility | None | $109.65 | $162.18 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $295.12 | Professional | None | $141.25 | $194.98 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | None | $154.88 | $154.88 | $213.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | None | $154.88 | $154.88 | $213.80 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $269.15 | Professional | None | $144.54 | $199.53 | $269.15 |
SummaCare Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $457.09 | Professional | None | $288.40 | $302.00 | $457.09 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $416.87 | Facility | None | $295.12 | $295.12 | $416.87 |
United Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $229.09 | Professional | None | $102.33 | $162.18 | $229.09 |
6 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 $48.98 Median $48.98 Typical High $257.04 | Professional | 52 · Reduced service | $48.98 | $48.98 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $104.71 | Professional | 53 · Discontinued | $19.50 | $19.50 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $77.62 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $52.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | RR · Rental | $19.50 | $19.50 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | UE · Used equipment | $144.54 | $144.54 | $144.54 |
Where Ohio sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 36th of 51
$170
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.