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 $104.71 Median $104.71 Typical High $275.42 | Facility | None | $104.71 | $104.71 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $257.04 | Professional | None | $104.71 | $104.71 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $416.87 | Facility | None | $186.21 | $229.09 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $251.19 | Professional | None | $93.33 | $100.00 | $251.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $70.79 Median $75.86 Typical High $100.00 | Professional | UE · Used equipment | $70.79 | $75.86 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $144.54 Typical High $194.98 | Facility | None | $97.72 | $144.54 | $194.98 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $263.03 | Professional | None | $125.89 | $173.78 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $42.66 Typical High $57.54 | Professional | None | $30.90 | $42.66 | $57.54 |
SummaCare Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $309.03 | Professional | None | $194.98 | $199.53 | $309.03 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $281.84 | Facility | None | $199.53 | $199.53 | $281.84 |
United Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $141.25 | Professional | None | $64.57 | $93.33 | $141.25 |
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 $51.29 Median $51.29 Typical High $128.82 | Professional | 52 · Reduced service | $51.29 | $51.29 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $51.29 | Professional | 53 · Discontinued | $20.89 | $20.89 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $38.02 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $25.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $10.96 | Professional | RR · Rental | $10.00 | $10.00 | $10.96 |
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· 36th of 51
$100
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.