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 $85.11 Median $234.42 Typical High $281.84 | Facility | None | $85.11 | $234.42 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $234.42 | Professional | None | $85.11 | $85.11 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $186.21 Typical High $346.74 | Facility | None | $151.36 | $186.21 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $204.17 | Professional | None | $77.62 | $87.10 | $204.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $57.54 Median $63.10 Typical High $83.18 | Professional | UE · Used equipment | $57.54 | $63.10 | $83.18 |
Aultcare Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | None | $138.04 | $138.04 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $158.49 | Facility | None | $79.43 | $117.49 | $158.49 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $213.80 | Professional | None | $102.33 | $141.25 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $93.33 | Professional | None | $64.57 | $64.57 | $93.33 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $123.03 | Professional | None | $66.07 | $91.20 | $123.03 |
SummaCare Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $251.19 | Professional | None | $162.18 | $162.18 | $251.19 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $190.55 | Facility | None | $77.62 | $77.62 | $190.55 |
United Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $114.82 | Professional | None | $52.48 | $75.86 | $114.82 |
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 $42.66 Median $42.66 Typical High $117.49 | Professional | 52 · Reduced service | $42.66 | $42.66 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $46.77 | Professional | 53 · Discontinued | $16.98 | $16.98 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $34.67 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $23.44 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $23.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $8.51 Typical High $9.12 | Professional | RR · Rental | $8.51 | $8.51 | $9.12 |
Where Ohio sits
The same service costs 2.8 times more in Kansas 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· 36th of 51
$85.11
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.