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 $177.83 Median $177.83 Typical High $954.99 | Facility | None | $177.83 | $177.83 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $660.69 | Professional | None | $177.83 | $177.83 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $436.52 Typical High $794.33 | Facility | None | $346.74 | $436.52 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $407.38 | Professional | None | $177.83 | $218.78 | $407.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $134.90 Median $151.36 Typical High $194.98 | Professional | UE · Used equipment | $134.90 | $151.36 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $199.53 Median $295.12 Typical High $398.11 | Facility | None | $199.53 | $295.12 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $537.03 | Professional | None | $257.04 | $354.81 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $288.40 | Professional | None | $154.88 | $213.80 | $288.40 |
SummaCare Setting Professional Modifier None Typical Low $371.54 Median $380.19 Typical High $588.84 | Professional | None | $371.54 | $380.19 | $588.84 |
United Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $501.19 | Facility | None | $151.36 | $190.55 | $501.19 |
United Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $281.84 | Professional | None | $120.23 | $181.97 | $281.84 |
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 $89.13 Median $89.13 Typical High $331.13 | Professional | 52 · Reduced service | $89.13 | $89.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $131.83 | Professional | 53 · Discontinued | $35.48 | $35.48 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $100.00 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $66.07 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $66.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $23.99 | Professional | RR · Rental | $21.88 | $21.88 | $23.99 |
Where Ohio sits
The same service costs 2.7 times more in Montana 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· 39th of 51
$219
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.