How much rates vary
Facilitymedian $65 · 10th to 90th $39 to $107Professionalmedian $32 · 10th to 90th $27 to $62
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 $32.36 Median $32.36 Typical High $91.20 | Facility | None | $32.36 | $32.36 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $91.20 | Professional | None | $32.36 | $32.36 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $72.44 Typical High $131.83 | Facility | None | $57.54 | $72.44 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $33.11 Typical High $77.62 | Professional | None | $29.51 | $33.11 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.39 Median $23.99 Typical High $33.11 | Professional | UE · Used equipment | $22.39 | $23.99 | $33.11 |
Aultcare Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | None | $52.48 | $52.48 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $26.92 Median $39.81 Typical High $53.70 | Facility | None | $26.92 | $39.81 | $53.70 |
CareSource Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $72.44 | Professional | None | $34.67 | $47.86 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $47.86 | Professional | None | $25.70 | $35.48 | $47.86 |
SummaCare Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $97.72 | Professional | None | $61.66 | $63.10 | $97.72 |
United Setting Facility Modifier None Typical Low $35.48 Median $51.29 Typical High $72.44 | Facility | None | $35.48 | $51.29 | $72.44 |
United Setting Professional Modifier None Typical Low $19.95 Median $28.84 Typical High $43.65 | Professional | None | $19.95 | $28.84 | $43.65 |
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 $16.22 Median $16.22 Typical High $45.71 | Professional | 52 · Reduced service | $16.22 | $16.22 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $18.20 | Professional | 53 · Discontinued | $6.46 | $6.46 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $13.80 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $9.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $3.24 Typical High $4.37 | Professional | RR · Rental | $3.24 | $3.24 | $4.37 |
Where Ohio sits
The same service costs 4.7 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· 37th of 51
$32.36
HI $132FL $28.18
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.