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 $53.70 Median $81.28 Typical High $323.59 | Facility | None | $53.70 | $81.28 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $295.12 | Professional | None | $53.70 | $53.70 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $218.78 | Facility | None | $95.50 | $117.49 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $131.83 | Professional | None | $46.77 | $50.12 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $46.77 Median $69.18 Typical High $93.33 | Facility | None | $46.77 | $69.18 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $125.89 | Professional | None | $60.26 | $83.18 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $100.00 | Professional | None | $53.70 | $74.13 | $100.00 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $162.18 | Professional | None | $102.33 | $107.15 | $162.18 |
United Setting Facility Modifier None Typical Low $16.98 Median $39.81 Typical High $117.49 | Facility | None | $16.98 | $39.81 | $117.49 |
United Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $72.44 | Professional | None | $33.11 | $47.86 | $72.44 |
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 $26.92 Median $26.92 Typical High $147.91 | Professional | 52 · Reduced service | $26.92 | $26.92 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $58.88 | Professional | 53 · Discontinued | $10.72 | $10.72 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $44.67 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $29.51 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $29.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $5.50 | Professional | RR · Rental | $5.01 | $5.01 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $40.74 | Professional | UE · Used equipment | $38.02 | $38.02 | $40.74 |
Where Ohio sits
The same service costs 3.3 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· 40th of 51
$50.12
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.