How much rates vary
Facilitymedian $224 · 10th to 90th $141 to $380Professionalmedian $105 · 10th to 90th $81 to $214
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 $112.20 Median $309.03 Typical High $380.19 | Facility | None | $112.20 | $309.03 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $346.74 | Professional | None | $112.20 | $112.20 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $251.19 Typical High $457.09 | Facility | None | $199.53 | $251.19 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $269.15 | Professional | None | $100.00 | $117.49 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $77.62 Median $85.11 Typical High $112.20 | Professional | UE · Used equipment | $77.62 | $85.11 | $112.20 |
Aultcare Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $158.49 Typical High $208.93 | Facility | None | $104.71 | $158.49 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $281.84 | Professional | None | $138.04 | $190.55 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $134.90 | Professional | None | $53.70 | $102.33 | $134.90 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $141.25 | Professional | None | $77.62 | $104.71 | $141.25 |
SummaCare Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $295.12 | Professional | None | $147.91 | $213.80 | $295.12 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $309.03 | Facility | None | $218.78 | $218.78 | $309.03 |
United Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $151.36 | Professional | None | $69.18 | $102.33 | $151.36 |
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 $56.23 Median $56.23 Typical High $173.78 | Professional | 52 · Reduced service | $56.23 | $56.23 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $70.79 | Professional | 53 · Discontinued | $22.39 | $22.39 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $52.48 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $34.67 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $34.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $14.79 | Professional | RR · Rental | $11.48 | $11.48 | $14.79 |
Where Ohio sits
The same service costs 2.0 times more in Wyoming than in New Jersey. 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· 37th of 51
$112
WY $209NJ $102
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.