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 $120.23 Median $120.23 Typical High $616.60 | Facility | None | $120.23 | $120.23 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $426.58 | Professional | None | $120.23 | $120.23 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $288.40 Typical High $537.03 | Facility | None | $234.42 | $288.40 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $316.23 | Professional | None | $123.03 | $138.04 | $316.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $102.33 Typical High $131.83 | Professional | UE · Used equipment | $93.33 | $102.33 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $173.78 Typical High $229.09 | Facility | None | $114.82 | $173.78 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $309.03 | Professional | None | $151.36 | $208.93 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
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 $251.19 Median $257.04 Typical High $398.11 | Professional | None | $251.19 | $257.04 | $398.11 |
United Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $302.00 | Facility | None | $107.15 | $131.83 | $302.00 |
United Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $177.83 | Professional | None | $81.28 | $123.03 | $177.83 |
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 $213.80 | Professional | 52 · Reduced service | $60.26 | $60.26 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $85.11 | Professional | 53 · Discontinued | $23.99 | $23.99 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $64.57 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $42.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $14.79 | Professional | RR · Rental | $13.80 | $13.80 | $14.79 |
Where Ohio sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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· 40th of 51
$132
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.