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 $93.33 Median $93.33 Typical High $302.00 | Facility | None | $93.33 | $93.33 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $281.84 | Professional | None | $93.33 | $93.33 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $204.17 Typical High $380.19 | Facility | None | $165.96 | $204.17 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $190.55 | Professional | None | $85.11 | $91.20 | $190.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $69.18 Typical High $91.20 | Professional | UE · Used equipment | $63.10 | $69.18 | $91.20 |
Aultcare Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $173.78 | Facility | None | $87.10 | $128.82 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $234.42 | Professional | None | $112.20 | $154.88 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $93.33 | Professional | None | $50.12 | $69.18 | $93.33 |
SummaCare Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $275.42 | Professional | None | $177.83 | $177.83 | $275.42 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $208.93 | Facility | None | $57.54 | $57.54 | $208.93 |
United Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $125.89 | Professional | None | $57.54 | $83.18 | $125.89 |
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 $46.77 Median $46.77 Typical High $141.25 | Professional | 52 · Reduced service | $46.77 | $46.77 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $56.23 | Professional | 53 · Discontinued | $18.62 | $18.62 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $41.69 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $28.18 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $28.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | RR · Rental | $9.12 | $9.12 | $10.00 |
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· 35th of 51
$91.20
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.