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 $47.86 Median $47.86 Typical High $147.91 | Facility | None | $47.86 | $47.86 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $138.04 | Professional | None | $47.86 | $47.86 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $104.71 Typical High $194.98 | Facility | None | $85.11 | $104.71 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $114.82 | Professional | None | $43.65 | $45.71 | $114.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $45.71 | Professional | RR · Rental | $4.57 | $4.57 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $32.36 Median $33.88 Typical High $45.71 | Professional | UE · Used equipment | $32.36 | $33.88 | $45.71 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $57.54 Typical High $75.86 | Facility | None | $38.02 | $57.54 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $48.98 Median $69.18 Typical High $102.33 | Professional | None | $48.98 | $69.18 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $70.79 | Professional | None | $38.02 | $51.29 | $70.79 |
SummaCare Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $144.54 | Professional | None | $91.20 | $91.20 | $144.54 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $104.71 | Facility | None | $51.29 | $51.29 | $104.71 |
United Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $64.57 | Professional | None | $29.51 | $42.66 | $64.57 |
4 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 $23.99 Median $23.99 Typical High $69.18 | Professional | 52 · Reduced service | $23.99 | $23.99 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $27.54 | Professional | 53 · Discontinued | $9.55 | $9.55 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $20.89 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $13.80 |
Where Ohio sits
The same service costs 3.5 times more in Hawaii than in West Virginia. 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· 39th of 51
$45.71
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.