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 $112.20 Median $112.20 Typical High $398.11 | Facility | None | $112.20 | $112.20 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $371.54 | Professional | None | $112.20 | $112.20 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $457.09 | Facility | None | $199.53 | $245.47 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $269.15 | Professional | None | $102.33 | $114.82 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $83.18 Typical High $109.65 | Professional | UE · Used equipment | $75.86 | $83.18 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $158.49 Typical High $208.93 | Facility | None | $104.71 | $158.49 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $281.84 | Professional | None | $134.90 | $190.55 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $165.96 | Professional | None | $89.13 | $123.03 | $165.96 |
SummaCare Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $338.84 | Professional | None | $213.80 | $213.80 | $338.84 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $257.04 | Facility | None | $102.33 | $102.33 | $257.04 |
United Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $151.36 | Professional | None | $69.18 | $100.00 | $151.36 |
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 $56.23 Median $56.23 Typical High $186.21 | Professional | 52 · Reduced service | $56.23 | $56.23 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $74.13 | Professional | 53 · Discontinued | $22.39 | $22.39 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $56.23 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $37.15 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $12.30 | Professional | RR · Rental | $11.48 | $11.48 | $12.30 |
Where Ohio sits
The same service costs 5.4 times more in Kansas than in West Virginia. 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· 38th of 51
$112
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.