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 $204.17 Median $204.17 Typical High $645.65 | Facility | None | $204.17 | $204.17 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $602.56 | Professional | None | $204.17 | $204.17 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $457.09 Typical High $831.76 | Facility | None | $363.08 | $457.09 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $426.58 | Professional | None | $186.21 | $208.93 | $426.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $141.25 Median $158.49 Typical High $204.17 | Professional | UE · Used equipment | $141.25 | $158.49 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $257.04 Typical High $346.74 | Facility | None | $173.78 | $257.04 | $346.74 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $467.74 | Professional | None | $223.87 | $309.03 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $302.00 | Professional | None | $162.18 | $223.87 | $302.00 |
SummaCare Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $616.60 | Professional | None | $389.05 | $398.11 | $616.60 |
United Setting Facility Modifier None Typical Low $229.09 Median $257.04 Typical High $467.74 | Facility | None | $229.09 | $257.04 | $467.74 |
United Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $275.42 | Professional | None | $128.82 | $186.21 | $275.42 |
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 $102.33 Median $102.33 Typical High $302.00 | Professional | 52 · Reduced service | $102.33 | $102.33 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $120.23 | Professional | 53 · Discontinued | $40.74 | $40.74 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $91.20 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $60.26 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | RR · Rental | $20.89 | $20.89 | $22.91 |
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· 36th of 51
$209
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.