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 $120.23 Median $120.23 Typical High $416.87 | Facility | None | $120.23 | $120.23 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $389.05 | Professional | None | $120.23 | $120.23 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $269.15 Typical High $489.78 | Facility | None | $218.78 | $269.15 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $295.12 | Professional | None | $109.65 | $131.83 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $91.20 Typical High $120.23 | Professional | UE · Used equipment | $83.18 | $91.20 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $169.82 Typical High $223.87 | Facility | None | $112.20 | $169.82 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $302.00 | Professional | None | $147.91 | $204.17 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $177.83 | Professional | None | $95.50 | $131.83 | $177.83 |
SummaCare Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $363.08 | Professional | None | $229.09 | $234.42 | $363.08 |
United Setting Facility Modifier None Typical Low $151.36 Median $263.03 Typical High $389.05 | Facility | None | $151.36 | $263.03 | $389.05 |
United Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $169.82 | Professional | None | $75.86 | $112.20 | $169.82 |
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 $60.26 Median $60.26 Typical High $194.98 | Professional | 52 · Reduced service | $60.26 | $60.26 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $77.62 | Professional | 53 · Discontinued | $23.99 | $23.99 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $57.54 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $38.90 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $38.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $16.98 | Professional | RR · Rental | $13.49 | $13.49 | $16.98 |
Where Ohio sits
The same service costs 8.1 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· 45th 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.