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 $51.29 Median $51.29 Typical High $173.78 | Facility | None | $51.29 | $51.29 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $162.18 | Professional | None | $51.29 | $51.29 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $112.20 Typical High $208.93 | Facility | None | $91.20 | $112.20 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $123.03 | Professional | None | $46.77 | $51.29 | $123.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $37.15 Typical High $50.12 | Professional | UE · Used equipment | $34.67 | $37.15 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $81.28 Typical High $109.65 | Facility | None | $53.70 | $81.28 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $147.91 | Professional | None | $70.79 | $97.72 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $54.95 Typical High $75.86 | Professional | None | $40.74 | $54.95 | $75.86 |
SummaCare Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $154.88 | Professional | None | $97.72 | $97.72 | $154.88 |
United Setting Facility Modifier None Typical Low $41.69 Median $45.71 Typical High $109.65 | Facility | None | $41.69 | $45.71 | $109.65 |
United Setting Professional Modifier None Typical Low $31.62 Median $45.71 Typical High $69.18 | Professional | None | $31.62 | $45.71 | $69.18 |
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 $25.70 Median $25.70 Typical High $81.28 | Professional | 52 · Reduced service | $25.70 | $25.70 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $32.36 | Professional | 53 · Discontinued | $10.23 | $10.23 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $24.55 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $16.22 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $16.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $5.37 | Professional | RR · Rental | $4.90 | $4.90 | $5.37 |
Where Ohio sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 39th of 51
$51.29
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.