How much rates vary
Facilitymedian $115 · 10th to 90th $62 to $191Professionalmedian $58 · 10th to 90th $45 to $132
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 $57.54 Median $158.49 Typical High $190.55 | Facility | None | $57.54 | $158.49 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $141.25 | Professional | None | $57.54 | $57.54 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | None | $81.28 | $95.50 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $229.09 | Facility | None | $102.33 | $125.89 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $141.25 | Professional | None | $50.12 | $57.54 | $141.25 |
Aultcare Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $95.50 | Facility | None | $47.86 | $72.44 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $154.88 | Professional | None | $87.10 | $128.82 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $64.57 | Facility | None | $60.26 | $61.66 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $67.61 | Facility | None | $60.26 | $61.66 | $67.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $151.36 | Professional | None | $44.67 | $63.10 | $151.36 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $104.71 | Professional | None | $56.23 | $77.62 | $104.71 |
SummaCare Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $173.78 | Professional | None | $107.15 | $117.49 | $173.78 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $131.83 | Facility | None | $72.44 | $72.44 | $131.83 |
United Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $75.86 | Professional | None | $35.48 | $51.29 | $75.86 |
6 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 $28.18 Median $28.18 Typical High $75.86 | Professional | 52 · Reduced service | $28.18 | $28.18 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $30.90 | Professional | 53 · Discontinued | $11.48 | $11.48 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $22.91 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $15.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $7.24 | Professional | RR · Rental | $5.62 | $5.62 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $47.86 | Professional | UE · Used equipment | $42.66 | $42.66 | $47.86 |
Where Ohio sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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
$57.54
WI $100NJ $47.86
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.