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 $162.18 Median $162.18 Typical High $870.96 | Facility | None | $162.18 | $162.18 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $794.33 | Professional | None | $162.18 | $162.18 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $354.81 Typical High $660.69 | Facility | None | $288.40 | $354.81 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $389.05 | Professional | None | $147.91 | $181.97 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $223.87 Typical High $302.00 | Facility | None | $151.36 | $223.87 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $407.38 | Professional | None | $194.98 | $269.15 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None | $138.04 | $138.04 | $186.21 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None | $138.04 | $138.04 | $186.21 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $239.88 | Professional | None | $128.82 | $173.78 | $239.88 |
SummaCare Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $489.78 | Professional | None | $309.03 | $309.03 | $489.78 |
United Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $407.38 | Facility | None | $199.53 | $263.03 | $407.38 |
United Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $218.78 | Professional | None | $100.00 | $151.36 | $218.78 |
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 $81.28 Median $81.28 Typical High $398.11 | Professional | 52 · Reduced service | $81.28 | $81.28 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $158.49 | Professional | 53 · Discontinued | $32.36 | $32.36 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $120.23 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $79.43 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $79.43 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $19.95 | Professional | RR · Rental | $18.20 | $18.20 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | UE · Used equipment | $138.04 | $138.04 | $147.91 |
Where Ohio sits
The same service costs 5.0 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· 41st of 51
$162
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.