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 $56.23 Median $56.23 Typical High $169.82 | Facility | None | $56.23 | $56.23 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $154.88 | Professional | None | $56.23 | $56.23 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $123.03 Typical High $229.09 | Facility | None | $100.00 | $123.03 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $117.49 | Professional | None | $51.29 | $56.23 | $117.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $42.66 Typical High $56.23 | Professional | UE · Used equipment | $38.02 | $42.66 | $56.23 |
Aultcare Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $79.43 Typical High $104.71 | Facility | None | $52.48 | $79.43 | $104.71 |
CareSource Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $141.25 | Professional | None | $69.18 | $95.50 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $60.26 | Professional | None | $32.36 | $44.67 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $169.82 | Professional | None | $107.15 | $109.65 | $169.82 |
United Setting Facility Modifier None Typical Low $32.36 Median $60.26 Typical High $128.82 | Facility | None | $32.36 | $60.26 | $128.82 |
United Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $75.86 | Professional | None | $34.67 | $51.29 | $75.86 |
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 $28.18 Median $28.18 Typical High $77.62 | Professional | 52 · Reduced service | $28.18 | $28.18 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $30.90 | Professional | 53 · Discontinued | $11.22 | $11.22 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $23.44 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $15.49 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $15.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $7.41 | Professional | RR · Rental | $5.62 | $5.62 | $7.41 |
Where Ohio sits
The same service costs 2.1 times more in Montana 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· 34th of 51
$56.23
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.