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 $70.79 Median $70.79 Typical High $213.80 | Facility | None | $70.79 | $70.79 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $194.98 | Professional | None | $70.79 | $70.79 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $154.88 Typical High $281.84 | Facility | None | $125.89 | $154.88 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $169.82 | Professional | None | $63.10 | $66.07 | $169.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $47.86 Typical High $67.61 | Professional | UE · Used equipment | $47.86 | $47.86 | $67.61 |
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 $56.23 Median $85.11 Typical High $112.20 | Facility | None | $56.23 | $85.11 | $112.20 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $151.36 | Professional | None | $72.44 | $100.00 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
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 $69.18 Median $72.44 Typical High $147.91 | Facility | None | $69.18 | $72.44 | $147.91 |
United Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $95.50 | Professional | None | $41.69 | $61.66 | $95.50 |
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 $97.72 | Professional | 52 · Reduced service | $34.67 | $34.67 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $39.81 | Professional | 53 · Discontinued | $14.13 | $14.13 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $29.51 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $19.50 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $19.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $6.46 Typical High $6.61 | Professional | RR · Rental | $6.46 | $6.46 | $6.61 |
Where Ohio sits
The same service costs 3.1 times more in Hawaii than in New Jersey. 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· 38th of 51
$66.07
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.