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 $58.88 Median $58.88 Typical High $177.83 | Facility | None | $58.88 | $58.88 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $165.96 | Professional | None | $58.88 | $58.88 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $239.88 | Facility | None | $104.71 | $128.82 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $141.25 | Professional | None | $53.70 | $53.70 | $141.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $56.23 | Professional | UE · Used equipment | $39.81 | $39.81 | $56.23 |
Aultcare Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | None | $95.50 | $95.50 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $83.18 Typical High $109.65 | Facility | None | $54.95 | $83.18 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $147.91 | Professional | None | $72.44 | $100.00 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $64.57 | Professional | None | $45.71 | $45.71 | $64.57 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $87.10 | Professional | None | $46.77 | $64.57 | $87.10 |
SummaCare Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $177.83 | Professional | None | $112.20 | $114.82 | $177.83 |
United Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $120.23 | Facility | None | $56.23 | $58.88 | $120.23 |
United Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $79.43 | Professional | None | $33.88 | $51.29 | $79.43 |
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 $29.51 Median $29.51 Typical High $83.18 | Professional | 52 · Reduced service | $29.51 | $29.51 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $33.11 | Professional | 53 · Discontinued | $11.75 | $11.75 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $25.12 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.62 | Professional | RR · Rental | $5.25 | $5.25 | $5.62 |
Where Ohio sits
The same service costs 3.2 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· 41st of 51
$53.70
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.