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 $52.48 Median $52.48 Typical High $194.98 | Facility | None | $52.48 | $52.48 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $181.97 | Professional | None | $52.48 | $52.48 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $117.49 Typical High $213.80 | Facility | None | $93.33 | $117.49 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $125.89 | Professional | None | $46.77 | $54.95 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $39.81 Typical High $52.48 | Professional | UE · Used equipment | $36.31 | $39.81 | $52.48 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $87.10 | Facility | None | $43.65 | $66.07 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $117.49 | Professional | None | $57.54 | $79.43 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $66.07 | Professional | None | $47.86 | $47.86 | $66.07 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $66.07 | Professional | None | $47.86 | $47.86 | $66.07 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $77.62 | Professional | None | $41.69 | $57.54 | $77.62 |
SummaCare Setting Professional Modifier None Typical Low $100.00 Median $102.33 Typical High $158.49 | Professional | None | $100.00 | $102.33 | $158.49 |
United Setting Facility Modifier None Typical Low $58.88 Median $60.26 Typical High $120.23 | Facility | None | $58.88 | $60.26 | $120.23 |
United Setting Professional Modifier None Typical Low $32.36 Median $47.86 Typical High $70.79 | Professional | None | $32.36 | $47.86 | $70.79 |
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 $26.30 Median $26.30 Typical High $91.20 | Professional | 52 · Reduced service | $26.30 | $26.30 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $36.31 | Professional | 53 · Discontinued | $10.47 | $10.47 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $27.54 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $18.20 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $7.08 | Professional | RR · Rental | $5.37 | $5.37 | $7.08 |
Where Ohio sits
The same service costs 3.6 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· 41st of 51
$52.48
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.