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 $524.81 | Facility | None | $114.82 | $114.82 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $363.08 | Professional | None | $114.82 | $114.82 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $281.84 Typical High $512.86 | Facility | None | $229.09 | $281.84 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $302.00 | Professional | None | $117.49 | $117.49 | $302.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $125.89 | Professional | UE · Used equipment | $89.13 | $89.13 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $190.55 | Facility | None | $95.50 | $144.54 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $257.04 | Professional | None | $125.89 | $173.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
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 $100.00 Median $120.23 Typical High $263.03 | Facility | None | $100.00 | $120.23 | $263.03 |
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 $181.97 | Professional | 52 · Reduced service | $57.54 | $57.54 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $72.44 | Professional | 53 · Discontinued | $22.91 | $22.91 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $54.95 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $36.31 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $36.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.75 Median $11.75 Typical High $12.59 | Professional | RR · Rental | $11.75 | $11.75 | $12.59 |
Where Ohio sits
The same service costs 2.9 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· 39th of 51
$117
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.