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 $95.50 Median $95.50 Typical High $239.88 | Facility | None | $95.50 | $95.50 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $223.87 | Professional | None | $95.50 | $95.50 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $389.05 | Facility | None | $169.82 | $208.93 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $229.09 | Professional | None | $87.10 | $93.33 | $229.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $64.57 Median $69.18 Typical High $93.33 | Professional | UE · Used equipment | $64.57 | $69.18 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $112.20 Typical High $151.36 | Facility | None | $75.86 | $112.20 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $204.17 | Professional | None | $97.72 | $134.90 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $138.04 | Professional | None | $75.86 | $102.33 | $138.04 |
SummaCare Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $288.40 | Professional | None | $181.97 | $181.97 | $288.40 |
United Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $204.17 | Facility | None | $95.50 | $100.00 | $204.17 |
United Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $128.82 | Professional | None | $57.54 | $85.11 | $128.82 |
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 $47.86 Median $47.86 Typical High $112.20 | Professional | 52 · Reduced service | $47.86 | $47.86 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $44.67 | Professional | 53 · Discontinued | $19.05 | $19.05 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $33.88 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $22.39 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.12 Median $9.12 Typical High $9.33 | Professional | RR · Rental | $9.12 | $9.12 | $9.33 |
Where Ohio sits
The same service costs 3.2 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
$93.33
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.