How much rates vary
Facilitymedian $105 · 10th to 90th $63 to $174Professionalmedian $52 · 10th to 90th $42 to $102
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 $52.48 Median $52.48 Typical High $181.97 | Facility | None | $52.48 | $52.48 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $158.49 | Professional | None | $52.48 | $52.48 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $213.80 | Facility | None | $93.33 | $114.82 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $125.89 | Professional | None | $47.86 | $54.95 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $40.74 Typical High $54.95 | Professional | UE · Used equipment | $35.48 | $40.74 | $54.95 |
Aultcare Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $74.13 Typical High $100.00 | Facility | None | $50.12 | $74.13 | $100.00 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $134.90 | Professional | None | $64.57 | $89.13 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $77.62 | Professional | None | $41.69 | $56.23 | $77.62 |
SummaCare Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $158.49 | Professional | None | $100.00 | $100.00 | $158.49 |
United Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $125.89 | Facility | None | $61.66 | $63.10 | $125.89 |
United Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $70.79 | Professional | None | $32.36 | $46.77 | $70.79 |
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 $26.30 Median $26.30 Typical High $85.11 | Professional | 52 · Reduced service | $26.30 | $26.30 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $33.88 | Professional | 53 · Discontinued | $10.47 | $10.47 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $25.70 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $16.98 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $16.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $7.24 | Professional | RR · Rental | $5.50 | $5.50 | $7.24 |
Where Ohio sits
The same service costs 4.3 times more in Hawaii 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· 41st of 51
$52.48
HI $195DE $45.71
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.