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 $151.36 Median $151.36 Typical High $537.03 | Facility | None | $151.36 | $151.36 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $501.19 | Professional | None | $151.36 | $151.36 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $338.84 Typical High $616.60 | Facility | None | $269.15 | $338.84 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $323.59 | Professional | None | $138.04 | $162.18 | $323.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $104.71 Median $117.49 Typical High $158.49 | Professional | UE · Used equipment | $104.71 | $117.49 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $204.17 Typical High $275.42 | Facility | None | $138.04 | $204.17 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $371.54 | Professional | None | $177.83 | $245.47 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $223.87 | Professional | None | $120.23 | $165.96 | $223.87 |
SummaCare Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $457.09 | Professional | None | $288.40 | $295.12 | $457.09 |
United Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $371.54 | Facility | None | $181.97 | $229.09 | $371.54 |
United Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $204.17 | Professional | None | $95.50 | $138.04 | $204.17 |
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 $75.86 Median $75.86 Typical High $251.19 | Professional | 52 · Reduced service | $75.86 | $75.86 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $100.00 | Professional | 53 · Discontinued | $30.20 | $30.20 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $74.13 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $50.12 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $50.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.22 Median $16.22 Typical High $21.38 | Professional | RR · Rental | $16.22 | $16.22 | $21.38 |
Where Ohio sits
The same service costs 4.7 times more in Hawaii than in Delaware. 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· 32nd of 51
$162
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.