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 $74.13 Median $208.93 Typical High $251.19 | Facility | None | $74.13 | $208.93 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $190.55 | Professional | None | $74.13 | $74.13 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $165.96 Typical High $302.00 | Facility | None | $134.90 | $165.96 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $181.97 | Professional | None | $67.61 | $81.28 | $181.97 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $56.23 Typical High $75.86 | Professional | UE · Used equipment | $51.29 | $56.23 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $138.04 Typical High $186.21 | Facility | None | $93.33 | $138.04 | $186.21 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $251.19 | Professional | None | $120.23 | $165.96 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $109.65 | Professional | None | $58.88 | $81.28 | $109.65 |
SummaCare Setting Professional Modifier None Typical Low $141.25 Median $144.54 Typical High $223.87 | Professional | None | $141.25 | $144.54 | $223.87 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $190.55 | Facility | None | $39.81 | $69.18 | $190.55 |
United Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $104.71 | Professional | None | $46.77 | $69.18 | $104.71 |
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 $37.15 Median $37.15 Typical High $95.50 | Professional | 52 · Reduced service | $37.15 | $37.15 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $38.02 | Professional | 53 · Discontinued | $15.14 | $15.14 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $28.18 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $19.05 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $19.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | RR · Rental | $8.13 | $8.13 | $10.96 |
Where Ohio sits
The same service costs 2.5 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· 47th of 51
$74.13
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.