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 $95.50 Median $95.50 Typical High $489.78 | Facility | None | $95.50 | $95.50 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $338.84 | Professional | None | $95.50 | $95.50 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $426.58 | Facility | None | $186.21 | $229.09 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $223.87 | Professional | None | $97.72 | $120.23 | $223.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $74.13 Median $81.28 Typical High $107.15 | Professional | UE · Used equipment | $74.13 | $81.28 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $151.36 Typical High $199.53 | Facility | None | $100.00 | $151.36 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $269.15 | Professional | None | $131.83 | $181.97 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $154.88 | Professional | None | $83.18 | $114.82 | $154.88 |
SummaCare Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $316.23 | Professional | None | $199.53 | $204.17 | $316.23 |
United Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $269.15 | Facility | None | $107.15 | $131.83 | $269.15 |
United Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $151.36 | Professional | None | $64.57 | $97.72 | $151.36 |
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 $47.86 Median $47.86 Typical High $169.82 | Professional | 52 · Reduced service | $47.86 | $47.86 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $67.61 | Professional | 53 · Discontinued | $19.05 | $19.05 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $51.29 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $12.88 | Professional | RR · Rental | $12.02 | $12.02 | $12.88 |
Where Ohio sits
The same service costs 3.0 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· 39th of 51
$120
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.