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 $74.13 Median $74.13 Typical High $380.19 | Facility | None | $74.13 | $74.13 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $263.03 | Professional | None | $74.13 | $74.13 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $181.97 Typical High $331.13 | Facility | None | $147.91 | $181.97 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $169.82 | Professional | None | $74.13 | $93.33 | $169.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $56.23 Median $63.10 Typical High $83.18 | Professional | UE · Used equipment | $56.23 | $63.10 | $83.18 |
Aultcare Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $114.82 Typical High $154.88 | Facility | None | $77.62 | $114.82 | $154.88 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $208.93 | Professional | None | $100.00 | $138.04 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $120.23 | Professional | None | $64.57 | $89.13 | $120.23 |
SummaCare Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $245.47 | Professional | None | $154.88 | $158.49 | $245.47 |
United Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $208.93 | Facility | None | $60.26 | $75.86 | $208.93 |
United Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $117.49 | Professional | None | $51.29 | $75.86 | $117.49 |
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 $37.15 Median $37.15 Typical High $131.83 | Professional | 52 · Reduced service | $37.15 | $37.15 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $52.48 | Professional | 53 · Discontinued | $15.14 | $15.14 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $39.81 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $26.30 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $26.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $10.00 | Professional | RR · Rental | $9.33 | $9.33 | $10.00 |
Where Ohio sits
The same service costs 2.9 times more in Montana than in Florida. 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
$91.20
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.