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 $263.03 Median $263.03 Typical High $630.96 | Facility | None | $263.03 | $263.03 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $575.44 | Professional | None | $263.03 | $263.03 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $588.84 Typical High $1,071.52 | Facility | None | $478.63 | $588.84 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $537.03 | Professional | None | $239.88 | $239.88 | $537.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | UE · Used equipment | $181.97 | $181.97 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $295.12 Typical High $398.11 | Facility | None | $194.98 | $295.12 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $537.03 | Professional | None | $257.04 | $354.81 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $389.05 | Professional | None | $208.93 | $288.40 | $389.05 |
SummaCare Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $794.33 | Professional | None | $501.19 | $512.86 | $794.33 |
United Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $537.03 | Facility | None | $147.91 | $204.17 | $537.03 |
United Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $354.81 | Professional | None | $151.36 | $234.42 | $354.81 |
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 $131.83 Median $131.83 Typical High $288.40 | Professional | 52 · Reduced service | $131.83 | $131.83 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $117.49 | Professional | 53 · Discontinued | $53.70 | $53.70 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $87.10 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $57.54 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $31.62 | Professional | RR · Rental | $23.99 | $23.99 | $31.62 |
Where Ohio sits
The same service costs 2.9 times more in Montana 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· 24th of 51
$245
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.