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 $95.50 Median $95.50 Typical High $331.13 | Facility | None | $95.50 | $95.50 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $302.00 | Professional | None | $95.50 | $95.50 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $380.19 | Facility | None | $169.82 | $208.93 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $229.09 | Professional | None | $85.11 | $102.33 | $229.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $64.57 Median $72.44 Typical High $95.50 | Professional | UE · Used equipment | $64.57 | $72.44 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $131.83 Typical High $177.83 | Facility | None | $89.13 | $131.83 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $239.88 | Professional | None | $114.82 | $158.49 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $138.04 | Professional | None | $74.13 | $102.33 | $138.04 |
SummaCare Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $281.84 | Professional | None | $177.83 | $181.97 | $281.84 |
United Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $239.88 | Facility | None | $89.13 | $107.15 | $239.88 |
United Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $131.83 | Professional | None | $58.88 | $87.10 | $131.83 |
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 $47.86 Median $47.86 Typical High $151.36 | Professional | 52 · Reduced service | $47.86 | $47.86 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $61.66 | Professional | 53 · Discontinued | $19.05 | $19.05 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $45.71 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $14.13 | Professional | RR · Rental | $10.72 | $10.72 | $14.13 |
Where Ohio sits
The same service costs 3.0 times more in Montana 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· 45th of 51
$95.50
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.