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 $85.11 Median $85.11 Typical High $263.03 | Facility | None | $85.11 | $85.11 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $245.47 | Professional | None | $85.11 | $85.11 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $346.74 | Facility | None | $151.36 | $190.55 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $204.17 | Professional | None | $72.44 | $79.43 | $204.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | UE · Used equipment | $58.88 | $58.88 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $131.83 | Facility | None | $66.07 | $100.00 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $177.83 | Professional | None | $85.11 | $117.49 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | None | $75.86 | $75.86 | $102.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | None | $75.86 | $75.86 | $102.33 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $125.89 | Professional | None | $67.61 | $93.33 | $125.89 |
SummaCare Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $257.04 | Professional | None | $162.18 | $165.96 | $257.04 |
United Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $177.83 | Facility | None | $75.86 | $87.10 | $177.83 |
United Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $114.82 | Professional | None | $51.29 | $75.86 | $114.82 |
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 $42.66 Median $42.66 Typical High $123.03 | Professional | 52 · Reduced service | $42.66 | $42.66 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $48.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $37.15 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $24.55 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $24.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.94 Median $7.94 Typical High $10.72 | Professional | RR · Rental | $7.94 | $7.94 | $10.72 |
Where Ohio sits
The same service costs 3.2 times more in Hawaii 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· 34th of 51
$79.43
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.