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 $87.10 Median $87.10 Typical High $257.04 | Facility | None | $87.10 | $87.10 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $239.88 | Professional | None | $87.10 | $87.10 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $190.55 Typical High $354.81 | Facility | None | $154.88 | $190.55 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $208.93 | Professional | None | $77.62 | $81.28 | $208.93 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $58.88 Typical High $85.11 | Professional | UE · Used equipment | $58.88 | $58.88 | $85.11 |
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 $87.10 Median $120.23 Typical High $177.83 | Professional | None | $87.10 | $120.23 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | None | $77.62 | $77.62 | $107.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | None | $77.62 | $77.62 | $107.15 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $128.82 | Professional | None | $69.18 | $95.50 | $128.82 |
SummaCare Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | None | $165.96 | $165.96 | $263.03 |
United Setting Facility Modifier None Typical Low $89.13 Median $154.88 Typical High $870.96 | Facility | None | $89.13 | $154.88 | $870.96 |
United Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $117.49 | Professional | None | $51.29 | $77.62 | $117.49 |
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 $43.65 Median $43.65 Typical High $120.23 | Professional | 52 · Reduced service | $43.65 | $43.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $47.86 | Professional | 53 · Discontinued | $17.38 | $17.38 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $35.48 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $23.99 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $23.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.94 Median $7.94 Typical High $8.13 | Professional | RR · Rental | $7.94 | $7.94 | $8.13 |
Where Ohio sits
The same service costs 5.1 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
$81.28
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.