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 $186.21 Median $186.21 Typical High $512.86 | Facility | None | $186.21 | $186.21 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $467.74 | Professional | None | $186.21 | $186.21 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $407.38 Typical High $741.31 | Facility | None | $331.13 | $407.38 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $446.68 | Professional | None | $158.49 | $186.21 | $446.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $125.89 Median $134.90 Typical High $177.83 | Professional | UE · Used equipment | $125.89 | $134.90 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $338.84 | Facility | None | $169.82 | $257.04 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $457.09 | Professional | None | $223.87 | $309.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $269.15 | Professional | None | $144.54 | $199.53 | $269.15 |
SummaCare Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $549.54 | Professional | None | $346.74 | $354.81 | $549.54 |
United Setting Facility Modifier None Typical Low $125.89 Median $173.78 Typical High $416.87 | Facility | None | $125.89 | $173.78 | $416.87 |
United Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $251.19 | Professional | None | $114.82 | $165.96 | $251.19 |
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 $93.33 Median $93.33 Typical High $234.42 | Professional | 52 · Reduced service | $93.33 | $93.33 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $93.33 | Professional | 53 · Discontinued | $37.15 | $37.15 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $70.79 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $46.77 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $46.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $18.62 Typical High $23.99 | Professional | RR · Rental | $18.62 | $18.62 | $23.99 |
Where Ohio sits
The same service costs 2.7 times more in Hawaii 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· 36th of 51
$186
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.