How much rates vary
Facilitymedian $105 · 10th to 90th $66 to $186Professionalmedian $52 · 10th to 90th $42 to $105
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 $177.83 | Facility | None | $52.48 | $52.48 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $165.96 | Professional | None | $52.48 | $52.48 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $213.80 | Facility | None | $93.33 | $114.82 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $125.89 | Professional | None | $47.86 | $53.70 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $39.81 Typical High $52.48 | Professional | UE · Used equipment | $35.48 | $39.81 | $52.48 |
Aultcare Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $48.98 Median $74.13 Typical High $97.72 | Facility | None | $48.98 | $74.13 | $97.72 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $131.83 | Professional | None | $64.57 | $89.13 | $131.83 |
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 $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $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 $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $56.23 Typical High $75.86 | Professional | None | $40.74 | $56.23 | $75.86 |
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 $102.33 Median $102.33 Typical High $144.54 | Facility | None | $102.33 | $102.33 | $144.54 |
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 $83.18 | Professional | 52 · Reduced service | $26.30 | $26.30 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $33.11 | Professional | 53 · Discontinued | $10.47 | $10.47 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $25.12 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $16.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.62 | Professional | RR · Rental | $5.25 | $5.25 | $5.62 |
Where Ohio sits
The same service costs 2.0 times more in Montana than in Vermont. 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
$52.48
MT $100VT $48.98
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.