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 $64.57 Median $64.57 Typical High $223.87 | Facility | None | $64.57 | $64.57 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $204.17 | Professional | None | $64.57 | $64.57 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $141.25 Typical High $263.03 | Facility | None | $114.82 | $141.25 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $154.88 | Professional | None | $57.54 | $69.18 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $91.20 Typical High $120.23 | Facility | None | $60.26 | $91.20 | $120.23 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $162.18 | Professional | None | $77.62 | $107.15 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | None | $61.66 | $61.66 | $85.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | None | $61.66 | $61.66 | $85.11 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $95.50 | Professional | None | $51.29 | $70.79 | $95.50 |
SummaCare Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $194.98 | Professional | None | $123.03 | $123.03 | $194.98 |
United Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $154.88 | Facility | None | $48.98 | $64.57 | $154.88 |
United Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $87.10 | Professional | None | $39.81 | $57.54 | $87.10 |
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 $32.36 Median $32.36 Typical High $102.33 | Professional | 52 · Reduced service | $32.36 | $32.36 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $40.74 | Professional | 53 · Discontinued | $12.88 | $12.88 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $30.90 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $20.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | RR · Rental | $6.92 | $6.92 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | UE · Used equipment | $52.48 | $52.48 | $52.48 |
Where Ohio sits
The same service costs 2.2 times more in Hawaii than in Alabama. 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· 42nd of 51
$64.57
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.