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 $67.61 Median $190.55 Typical High $229.09 | Facility | None | $67.61 | $190.55 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $194.98 | Professional | None | $67.61 | $67.61 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $275.42 | Facility | None | $123.03 | $151.36 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $165.96 | Professional | None | $61.66 | $66.07 | $165.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $50.12 Typical High $67.61 | Professional | UE · Used equipment | $46.77 | $50.12 | $67.61 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $95.50 Typical High $128.82 | Facility | None | $64.57 | $95.50 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $173.78 | Professional | None | $83.18 | $114.82 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $125.89 | Professional | None | $67.61 | $93.33 | $125.89 |
SummaCare Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $204.17 | Professional | None | $128.82 | $131.83 | $204.17 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $186.21 | Facility | None | $131.83 | $131.83 | $186.21 |
United Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $91.20 | Professional | None | $42.66 | $61.66 | $91.20 |
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 $33.88 Median $33.88 Typical High $97.72 | Professional | 52 · Reduced service | $33.88 | $33.88 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $38.90 | Professional | 53 · Discontinued | $13.80 | $13.80 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $29.51 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $19.50 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $19.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $7.24 | Professional | RR · Rental | $6.61 | $6.61 | $7.24 |
Where Ohio sits
The same service costs 2.6 times more in Hawaii 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· 38th of 51
$66.07
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.