How much rates vary
Facilitymedian $126 · 10th to 90th $68 to $209Professionalmedian $63 · 10th to 90th $50 to $123
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 $63.10 Median $173.78 Typical High $208.93 | Facility | None | $63.10 | $173.78 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $169.82 | Professional | None | $63.10 | $63.10 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $89.13 | Professional | None | $57.54 | $75.86 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $257.04 | Facility | None | $112.20 | $138.04 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $151.36 | Professional | None | $56.23 | $63.10 | $151.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $45.71 Typical High $63.10 | Professional | UE · Used equipment | $42.66 | $45.71 | $63.10 |
Aultcare Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $89.13 Typical High $117.49 | Facility | None | $58.88 | $89.13 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $190.55 | Professional | None | $107.15 | $158.49 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Facility | None | $67.61 | $67.61 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $34.67 Median $67.61 Typical High $75.86 | Facility | None | $34.67 | $67.61 | $75.86 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $67.61 | Professional | None | $50.12 | $57.54 | $67.61 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $91.20 | Professional | None | $48.98 | $67.61 | $91.20 |
SummaCare Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
SummaCare Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $162.18 | Professional | None | $81.28 | $120.23 | $162.18 |
United Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $138.04 | Facility | None | $67.61 | $77.62 | $138.04 |
United Setting Professional Modifier None Typical Low $38.90 Median $56.23 Typical High $85.11 | Professional | None | $38.90 | $56.23 | $85.11 |
5 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 $31.62 Median $31.62 Typical High $81.28 | Professional | 52 · Reduced service | $31.62 | $31.62 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $33.11 | Professional | 53 · Discontinued | $12.59 | $12.59 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $24.55 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $16.22 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $16.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $6.61 | Professional | RR · Rental | $6.17 | $6.17 | $6.61 |
Where Ohio sits
The same service costs 4.1 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· 33rd of 51
$63.10
HI $209DE $51.29
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.