How much rates vary
Facilitymedian $251 · 10th to 90th $112 to $417Professionalmedian $115 · 10th to 90th $83 to $240
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 $446.68 | Facility | None | $114.82 | $114.82 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $309.03 | Professional | None | $114.82 | $114.82 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $275.42 Typical High $512.86 | Facility | None | $223.87 | $275.42 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $257.04 | Professional | None | $107.15 | $114.82 | $257.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $85.11 Typical High $112.20 | Professional | UE · Used equipment | $79.43 | $85.11 | $112.20 |
Aultcare Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $131.83 Typical High $173.78 | Facility | None | $87.10 | $131.83 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $234.42 | Professional | None | $114.82 | $158.49 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
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 $239.88 Typical High $380.19 | Professional | None | $239.88 | $239.88 | $380.19 |
United Setting Facility Modifier None Typical Low $75.86 Median $104.71 Typical High $239.88 | Facility | None | $75.86 | $104.71 | $239.88 |
United Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $169.82 | Professional | None | $77.62 | $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 $154.88 | Professional | 52 · Reduced service | $57.54 | $57.54 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $63.10 | Professional | 53 · Discontinued | $22.91 | $22.91 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $46.77 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $30.90 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $30.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $11.48 | Professional | RR · Rental | $10.72 | $10.72 | $11.48 |
Where Ohio sits
The same service costs 2.8 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· 28th of 51
$115
HI $234DE $83.18
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.