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 $114.82 Median $114.82 Typical High $549.54 | Facility | None | $114.82 | $114.82 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $380.19 | Professional | None | $114.82 | $114.82 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $281.84 Typical High $512.86 | Facility | None | $223.87 | $281.84 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $302.00 | Professional | None | $114.82 | $134.90 | $302.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $100.00 Typical High $134.90 | Professional | UE · Used equipment | $89.13 | $100.00 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $223.87 | Facility | None | $112.20 | $165.96 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $302.00 | Professional | None | $144.54 | $199.53 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None | $102.33 | $102.33 | $138.04 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None | $102.33 | $102.33 | $138.04 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $186.21 | Professional | None | $100.00 | $138.04 | $186.21 |
SummaCare Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $380.19 | Professional | None | $239.88 | $245.47 | $380.19 |
United Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $302.00 | Facility | None | $147.91 | $154.88 | $302.00 |
United Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $169.82 | Professional | None | $79.43 | $117.49 | $169.82 |
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 $57.54 Median $57.54 Typical High $190.55 | Professional | 52 · Reduced service | $57.54 | $57.54 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $75.86 | Professional | 53 · Discontinued | $22.91 | $22.91 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $57.54 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $38.02 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $38.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $14.45 | Professional | RR · Rental | $13.49 | $13.49 | $14.45 |
Where Ohio sits
The same service costs 3.5 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· 44th of 51
$129
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.