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 $66.07 Median $66.07 Typical High $234.42 | Facility | None | $66.07 | $66.07 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $218.78 | Professional | None | $66.07 | $66.07 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $144.54 Typical High $269.15 | Facility | None | $117.49 | $144.54 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $158.49 | Professional | None | $58.88 | $69.18 | $158.49 |
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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $74.13 | Professional | None | $53.70 | $53.70 | $74.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $74.13 | Professional | None | $53.70 | $53.70 | $74.13 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $95.50 | Professional | None | $52.48 | $70.79 | $95.50 |
SummaCare Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $194.98 | Professional | None | $125.89 | $125.89 | $194.98 |
United Setting Facility Modifier None Typical Low $77.62 Median $79.43 Typical High $158.49 | Facility | None | $77.62 | $79.43 | $158.49 |
United Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $89.13 | Professional | None | $40.74 | $58.88 | $89.13 |
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 $33.11 Median $33.11 Typical High $109.65 | Professional | 52 · Reduced service | $33.11 | $33.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $43.65 | Professional | 53 · Discontinued | $13.18 | $13.18 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $33.11 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $21.88 |
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 $51.29 Median $51.29 Typical High $51.29 | Professional | UE · Used equipment | $51.29 | $51.29 | $51.29 |
Where Ohio sits
The same service costs 3.1 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· 43rd of 51
$66.07
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.