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 $138.04 Median $138.04 Typical High $436.52 | Facility | None | $138.04 | $138.04 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $407.38 | Professional | None | $138.04 | $138.04 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $302.00 Typical High $562.34 | Facility | None | $245.47 | $302.00 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $331.13 | Professional | None | $107.15 | $138.04 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $102.33 Typical High $138.04 | Professional | UE · Used equipment | $93.33 | $102.33 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $173.78 Typical High $229.09 | Facility | None | $114.82 | $173.78 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $309.03 | Professional | None | $151.36 | $208.93 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $204.17 | Professional | None | $109.65 | $151.36 | $204.17 |
SummaCare Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $416.87 | Professional | None | $263.03 | $269.15 | $416.87 |
United Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $316.23 | Facility | None | $154.88 | $213.80 | $316.23 |
United Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $186.21 | Professional | None | $85.11 | $123.03 | $186.21 |
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 $69.18 Median $69.18 Typical High $204.17 | Professional | 52 · Reduced service | $69.18 | $69.18 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $81.28 | Professional | 53 · Discontinued | $27.54 | $27.54 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $60.26 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $40.74 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $18.62 | Professional | RR · Rental | $13.80 | $13.80 | $18.62 |
Where Ohio sits
The same service costs 4.4 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· 39th of 51
$138
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.