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 $61.66 Median $114.82 Typical High $208.93 | Facility | None | $61.66 | $114.82 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $213.80 | Professional | None | $61.66 | $61.66 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $138.04 Typical High $251.19 | Facility | None | $109.65 | $138.04 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $125.89 | Professional | None | $56.23 | $61.66 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $45.71 Typical High $63.10 | Professional | UE · Used equipment | $42.66 | $45.71 | $63.10 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $79.43 Typical High $107.15 | Facility | None | $52.48 | $79.43 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $144.54 | Professional | None | $69.18 | $95.50 | $144.54 |
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 $48.98 Median $67.61 Typical High $91.20 | Professional | None | $48.98 | $67.61 | $91.20 |
SummaCare Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $186.21 | Professional | None | $117.49 | $120.23 | $186.21 |
United Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $141.25 | Facility | None | $61.66 | $69.18 | $141.25 |
United Setting Professional Modifier None Typical Low $38.02 Median $56.23 Typical High $83.18 | Professional | None | $38.02 | $56.23 | $83.18 |
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 $30.90 Median $30.90 Typical High $107.15 | Professional | 52 · Reduced service | $30.90 | $30.90 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $42.66 | Professional | 53 · Discontinued | $12.30 | $12.30 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $31.62 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $21.38 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $21.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $6.61 | Professional | RR · Rental | $6.17 | $6.17 | $6.61 |
Where Ohio sits
The same service costs 3.5 times more in Hawaii than in Florida. 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
$61.66
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.