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 $74.13 Median $74.13 Typical High $295.12 | Facility | None | $74.13 | $74.13 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $275.42 | Professional | None | $74.13 | $74.13 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $162.18 Typical High $302.00 | Facility | None | $131.83 | $162.18 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $151.36 | Professional | None | $67.61 | $85.11 | $151.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $56.23 Typical High $74.13 | Professional | UE · Used equipment | $51.29 | $56.23 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $104.71 Typical High $138.04 | Facility | None | $69.18 | $104.71 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $186.21 | Professional | None | $89.13 | $125.89 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $109.65 | Professional | None | $58.88 | $81.28 | $109.65 |
SummaCare Setting Professional Modifier None Typical Low $141.25 Median $144.54 Typical High $223.87 | Professional | None | $141.25 | $144.54 | $223.87 |
United Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $190.55 | Facility | None | $93.33 | $114.82 | $190.55 |
United Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $104.71 | Professional | None | $45.71 | $69.18 | $104.71 |
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 $37.15 Median $37.15 Typical High $138.04 | Professional | 52 · Reduced service | $37.15 | $37.15 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $54.95 | Professional | 53 · Discontinued | $14.79 | $14.79 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $41.69 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $27.54 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $27.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $10.96 | Professional | RR · Rental | $8.51 | $8.51 | $10.96 |
Where Ohio sits
The same service costs 5.1 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· 43rd of 51
$79.43
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.