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 $138.04 Median $138.04 Typical High $616.60 | Facility | None | $138.04 | $138.04 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $426.58 | Professional | None | $138.04 | $138.04 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $331.13 Typical High $616.60 | Facility | None | $269.15 | $331.13 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $363.08 | Professional | None | $134.90 | $141.25 | $363.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $104.71 Typical High $151.36 | Professional | UE · Used equipment | $102.33 | $104.71 | $151.36 |
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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $181.97 | Professional | None | $131.83 | $131.83 | $181.97 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $181.97 | Professional | None | $131.83 | $131.83 | $181.97 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $223.87 | Professional | None | $120.23 | $165.96 | $223.87 |
SummaCare Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $457.09 | Professional | None | $288.40 | $295.12 | $457.09 |
United Setting Facility Modifier None Typical Low $147.91 Median $173.78 Typical High $302.00 | Facility | None | $147.91 | $173.78 | $302.00 |
United Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $204.17 | Professional | None | $93.33 | $141.25 | $204.17 |
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 $69.18 Median $69.18 Typical High $213.80 | Professional | 52 · Reduced service | $69.18 | $69.18 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $85.11 | Professional | 53 · Discontinued | $27.54 | $27.54 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $64.57 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $42.66 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $42.66 |
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 Washington, DC. 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· 33rd of 51
$141
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.