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 $123.03 Median $123.03 Typical High $549.54 | Facility | None | $123.03 | $123.03 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $380.19 | Professional | None | $123.03 | $123.03 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $295.12 Typical High $549.54 | Facility | None | $239.88 | $295.12 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $275.42 | Professional | None | $125.89 | $125.89 | $275.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $95.50 Typical High $128.82 | Professional | UE · Used equipment | $93.33 | $95.50 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $158.49 Typical High $213.80 | Facility | None | $104.71 | $158.49 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $288.40 | Professional | None | $138.04 | $190.55 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $194.98 | Professional | None | $104.71 | $144.54 | $194.98 |
SummaCare Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $398.11 | Professional | None | $257.04 | $257.04 | $398.11 |
United Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $288.40 | Facility | None | $138.04 | $141.25 | $288.40 |
United Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $181.97 | Professional | None | $83.18 | $123.03 | $181.97 |
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 $60.26 Median $60.26 Typical High $190.55 | Professional | 52 · Reduced service | $60.26 | $60.26 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $75.86 | Professional | 53 · Discontinued | $24.55 | $24.55 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $56.23 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $38.02 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $38.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $13.80 | Professional | RR · Rental | $12.59 | $12.59 | $13.80 |
Where Ohio sits
The same service costs 2.8 times more in Hawaii 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· 42nd of 51
$126
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.