How much rates vary
Facilitymedian $219 · 10th to 90th $126 to $363Professionalmedian $110 · 10th to 90th $93 to $234
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 $109.65 Median $154.88 Typical High $363.08 | Facility | None | $109.65 | $154.88 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $338.84 | Professional | None | $109.65 | $109.65 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $154.88 | Professional | None | $114.82 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $239.88 Typical High $436.52 | Facility | None | $194.98 | $239.88 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $269.15 | Professional | None | $95.50 | $120.23 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | RR · Rental | $11.48 | $11.48 | $12.59 |
Aultcare Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $151.36 Typical High $204.17 | Facility | None | $102.33 | $151.36 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $323.59 | Professional | None | $181.97 | $275.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $134.90 | Facility | None | $107.15 | $125.89 | $134.90 |
Cigna Setting Facility Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | RR · Rental | $12.59 | $12.59 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $134.90 | Facility | None | $107.15 | $125.89 | $134.90 |
Medical Mutual of Ohio Setting Facility Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | RR · Rental | $12.59 | $12.59 | $12.59 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $257.04 | Professional | None | $93.33 | $93.33 | $257.04 |
Medical Mutual of Ohio Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $141.25 | Professional | None | $75.86 | $104.71 | $141.25 |
SummaCare Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $331.13 | Professional | None | $165.96 | $204.17 | $331.13 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $295.12 | Facility | None | $208.93 | $208.93 | $295.12 |
United Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $147.91 | Professional | None | $67.61 | $97.72 | $147.91 |
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 $53.70 Median $53.70 Typical High $169.82 | Professional | 52 · Reduced service | $53.70 | $53.70 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $67.61 | Professional | 53 · Discontinued | $21.88 | $21.88 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $50.12 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | UE · Used equipment | $87.10 | $87.10 | $93.33 |
Where Ohio sits
The same service costs 2.1 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· 35th of 51
$117
HI $200DE $93.33
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.