How much rates vary
Facilitymedian $170 · 10th to 90th $102 to $282Professionalmedian $85 · 10th to 90th $71 to $162
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 $85.11 Median $85.11 Typical High $234.42 | Facility | None | $85.11 | $85.11 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $229.09 | Professional | None | $85.11 | $85.11 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | None | $112.20 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $186.21 Typical High $338.84 | Facility | None | $151.36 | $186.21 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $204.17 | Professional | None | $74.13 | $87.10 | $204.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $57.54 Median $63.10 Typical High $83.18 | Professional | UE · Used equipment | $57.54 | $63.10 | $83.18 |
Aultcare Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | None | $134.90 | $134.90 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $109.65 Typical High $147.91 | Facility | None | $74.13 | $109.65 | $147.91 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $234.42 | Professional | None | $131.83 | $199.53 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $158.49 | Professional | None | $85.11 | $117.49 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $257.04 | Professional | None | $109.65 | $158.49 | $257.04 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $190.55 | Facility | None | $87.10 | $87.10 | $190.55 |
United Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $114.82 | Professional | None | $52.48 | $75.86 | $114.82 |
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 $42.66 Median $42.66 Typical High $112.20 | Professional | 52 · Reduced service | $42.66 | $42.66 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $45.71 | Professional | 53 · Discontinued | $16.98 | $16.98 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $33.88 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $22.91 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $22.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $9.55 | Professional | RR · Rental | $8.51 | $8.51 | $9.55 |
Where Ohio sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 33rd of 51
$87.10
HI $214NJ $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.