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 $181.97 Median $181.97 Typical High $549.54 | Facility | None | $181.97 | $181.97 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $512.86 | Professional | None | $181.97 | $181.97 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $398.11 Typical High $741.31 | Facility | None | $323.59 | $398.11 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $436.52 | Professional | None | $154.88 | $165.96 | $436.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $123.03 Typical High $173.78 | Professional | UE · Used equipment | $117.49 | $123.03 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $263.03 | Facility | None | $128.82 | $194.98 | $263.03 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $354.81 | Professional | None | $169.82 | $234.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $269.15 | Professional | None | $144.54 | $199.53 | $269.15 |
SummaCare Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $549.54 | Professional | None | $346.74 | $354.81 | $549.54 |
United Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $346.74 | Facility | None | $141.25 | $169.82 | $346.74 |
United Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $245.47 | Professional | None | $97.72 | $158.49 | $245.47 |
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 $91.20 Median $91.20 Typical High $257.04 | Professional | 52 · Reduced service | $91.20 | $91.20 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $102.33 | Professional | 53 · Discontinued | $36.31 | $36.31 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $75.86 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $51.29 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $15.49 Typical High $16.98 | Professional | RR · Rental | $15.49 | $15.49 | $16.98 |
Where Ohio sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 25th of 51
$166
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.