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 $138.04 Median $138.04 Typical High $363.08 | Facility | None | $138.04 | $138.04 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $331.13 | Professional | None | $138.04 | $138.04 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $302.00 Typical High $549.54 | Facility | None | $245.47 | $302.00 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $331.13 | Professional | None | $117.49 | $123.03 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $93.33 Typical High $128.82 | Professional | UE · Used equipment | $87.10 | $93.33 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $144.54 Typical High $194.98 | Facility | None | $97.72 | $144.54 | $194.98 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $263.03 | Professional | None | $125.89 | $173.78 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $199.53 | Professional | None | $107.15 | $147.91 | $199.53 |
SummaCare Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $407.38 | Professional | None | $257.04 | $263.03 | $407.38 |
United Setting Facility Modifier None Typical Low $95.50 Median $104.71 Typical High $257.04 | Facility | None | $95.50 | $104.71 | $257.04 |
United Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $186.21 | Professional | None | $74.13 | $120.23 | $186.21 |
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 $67.61 Median $67.61 Typical High $165.96 | Professional | 52 · Reduced service | $67.61 | $67.61 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $66.07 | Professional | 53 · Discontinued | $27.54 | $27.54 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $50.12 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $33.11 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $33.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.75 Median $11.75 Typical High $12.59 | Professional | RR · Rental | $11.75 | $11.75 | $12.59 |
Where Ohio sits
The same service costs 2.8 times more in Wisconsin than in Delaware. 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· 22nd of 51
$123
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.