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 $42.66 Median $42.66 Typical High $165.96 | Facility | None | $42.66 | $42.66 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $114.82 | Professional | None | $42.66 | $42.66 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $104.71 Typical High $190.55 | Facility | None | $83.18 | $104.71 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $112.20 | Professional | None | $43.65 | $48.98 | $112.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.11 Median $35.48 Typical High $47.86 | Professional | UE · Used equipment | $33.11 | $35.48 | $47.86 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $89.13 | Facility | None | $43.65 | $66.07 | $89.13 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $120.23 | Professional | None | $57.54 | $79.43 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $102.33 | Professional | None | $54.95 | $75.86 | $102.33 |
SummaCare Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $141.25 | Professional | None | $89.13 | $91.20 | $141.25 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $128.82 | Facility | None | $91.20 | $91.20 | $128.82 |
United Setting Professional Modifier None Typical Low $29.51 Median $43.65 Typical High $63.10 | Professional | None | $29.51 | $43.65 | $63.10 |
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 $21.38 Median $21.38 Typical High $57.54 | Professional | 52 · Reduced service | $21.38 | $21.38 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $22.91 | Professional | 53 · Discontinued | $8.51 | $8.51 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $17.38 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $11.48 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $11.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $5.13 | Professional | RR · Rental | $4.79 | $4.79 | $5.13 |
Where Ohio sits
The same service costs 2.0 times more in Montana 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· 45th of 51
$50.12
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.