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 $69.18 Typical High $186.21 | Facility | None | $69.18 | $69.18 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $173.78 | Professional | None | $69.18 | $69.18 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $154.88 Typical High $281.84 | Facility | None | $123.03 | $154.88 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $165.96 | Professional | None | $53.70 | $63.10 | $165.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $47.86 Typical High $64.57 | Professional | UE · Used equipment | $44.67 | $47.86 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $125.89 | Facility | None | $63.10 | $93.33 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $169.82 | Professional | None | $81.28 | $112.20 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $102.33 | Professional | None | $54.95 | $75.86 | $102.33 |
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 $64.57 Median $72.44 Typical High $131.83 | Facility | None | $64.57 | $72.44 | $131.83 |
United Setting Professional Modifier None Typical Low $37.15 Median $60.26 Typical High $93.33 | Professional | None | $37.15 | $60.26 | $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 $87.10 | Professional | 52 · Reduced service | $34.67 | $34.67 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $34.67 | Professional | 53 · Discontinued | $13.80 | $13.80 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $26.30 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $17.38 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $17.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $7.94 | Professional | RR · Rental | $6.03 | $6.03 | $7.94 |
Where Ohio sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 27th 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.