How much rates vary
Facilitymedian $55 · 10th to 90th $32 to $91Professionalmedian $28 · 10th to 90th $23 to $56
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 $25.12 Median $30.20 Typical High $70.79 | Facility | None | $25.12 | $30.20 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $83.18 | Professional | None | $25.12 | $25.12 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $60.26 Typical High $112.20 | Facility | None | $48.98 | $60.26 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $31.62 Typical High $66.07 | Professional | None | $25.12 | $31.62 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.62 Median $20.89 Typical High $26.92 | Professional | UE · Used equipment | $18.62 | $20.89 | $26.92 |
Aultcare Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
CareSource Setting Facility Modifier None Typical Low $26.30 Median $39.81 Typical High $52.48 | Facility | None | $26.30 | $39.81 | $52.48 |
CareSource Setting Professional Modifier None Typical Low $47.86 Median $70.79 Typical High $85.11 | Professional | None | $47.86 | $70.79 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $34.67 | Facility | None | $30.20 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $19.05 Median $34.67 Typical High $50.12 | Facility | None | $19.05 | $34.67 | $50.12 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $30.90 | Professional | None | $25.70 | $25.70 | $30.90 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $32.36 Typical High $43.65 | Professional | None | $23.44 | $32.36 | $43.65 |
SummaCare Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $83.18 | Professional | None | $52.48 | $52.48 | $83.18 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $60.26 | Facility | None | $16.22 | $29.51 | $60.26 |
United Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $38.90 | Professional | None | $16.98 | $25.70 | $38.90 |
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 $12.59 Median $12.59 Typical High $30.20 | Professional | 52 · Reduced service | $12.59 | $12.59 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $12.30 | Professional | 53 · Discontinued | $5.01 | $5.01 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $9.12 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $6.17 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $6.17 |
Aetna Setting Professional Modifier RR · Rental Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | RR · Rental | $47.86 | $47.86 | $47.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $3.24 Typical High $3.47 | Professional | RR · Rental | $3.24 | $3.24 | $3.47 |
Where Ohio sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 38th of 51
$30.20
HI $77.62DC $24.55
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.