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 $131.83 Median $131.83 Typical High $354.81 | Facility | None | $131.83 | $131.83 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $331.13 | Professional | None | $131.83 | $131.83 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $288.40 Typical High $537.03 | Facility | None | $234.42 | $288.40 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $269.15 | Professional | None | $120.23 | $120.23 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $125.89 | Professional | UE · Used equipment | $89.13 | $89.13 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $204.17 | Facility | None | $102.33 | $154.88 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $275.42 | Professional | None | $134.90 | $186.21 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $190.55 | Professional | None | $102.33 | $141.25 | $190.55 |
SummaCare Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $389.05 | Professional | None | $251.19 | $251.19 | $389.05 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $269.15 | Facility | None | $87.10 | $100.00 | $269.15 |
United Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $177.83 | Professional | None | $77.62 | $117.49 | $177.83 |
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 $66.07 Median $66.07 Typical High $165.96 | Professional | 52 · Reduced service | $66.07 | $66.07 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $66.07 | Professional | 53 · Discontinued | $26.30 | $26.30 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $50.12 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $33.11 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $33.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | RR · Rental | $12.02 | $12.02 | $12.30 |
Where Ohio sits
The same service costs 2.5 times more in Montana than in Florida. 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· 44th of 51
$120
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.