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 $181.97 Median $512.86 Typical High $616.60 | Facility | None | $181.97 | $512.86 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $269.15 | Professional | None | $181.97 | $181.97 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $46.77 Typical High $63.10 | Professional | None | $39.81 | $46.77 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $25.70 Typical High $38.90 | Professional | None | $20.42 | $25.70 | $38.90 |
United Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
6 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 $91.20 Median $91.20 Typical High $134.90 | Professional | 52 · Reduced service | $91.20 | $91.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $53.70 | Professional | 53 · Discontinued | $37.15 | $37.15 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $40.74 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $26.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $42.66 | $42.66 | $42.66 |
Where Ohio sits
The same service costs 26.3 times more in Rhode Island than in South Carolina. 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
$58.88
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.