How much rates vary
Facilitymedian $71 · 10th to 90th $37 to $129Professionalmedian $35 · 10th to 90th $27 to $68
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 $35.48 Median $35.48 Typical High $123.03 | Facility | None | $35.48 | $35.48 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $114.82 | Professional | None | $35.48 | $35.48 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $77.62 Typical High $144.54 | Facility | None | $63.10 | $77.62 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $34.67 Typical High $74.13 | Professional | None | $32.36 | $34.67 | $74.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $25.70 Typical High $34.67 | Professional | UE · Used equipment | $23.99 | $25.70 | $34.67 |
Aultcare Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
CareSource Setting Facility Modifier None Typical Low $33.11 Median $50.12 Typical High $66.07 | Facility | None | $33.11 | $50.12 | $66.07 |
CareSource Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $89.13 | Professional | None | $42.66 | $60.26 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | None | $26.92 | $26.92 | $37.15 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $64.57 | Professional | None | $34.67 | $47.86 | $64.57 |
SummaCare Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $107.15 | Professional | None | $67.61 | $67.61 | $107.15 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $95.50 | Facility | None | $67.61 | $67.61 | $95.50 |
United Setting Professional Modifier None Typical Low $21.88 Median $31.62 Typical High $47.86 | Professional | None | $21.88 | $31.62 | $47.86 |
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 $17.78 Median $17.78 Typical High $57.54 | Professional | 52 · Reduced service | $17.78 | $17.78 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $22.91 | Professional | 53 · Discontinued | $7.08 | $7.08 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $17.38 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $11.48 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $11.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $4.68 | Professional | RR · Rental | $3.47 | $3.47 | $4.68 |
Where Ohio sits
The same service costs 2.6 times more in Montana 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· 32nd of 51
$34.67
MT $69.18DE $26.92
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.