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 $54.95 Median $54.95 Typical High $223.87 | Facility | None | $54.95 | $54.95 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $154.88 | Professional | None | $54.95 | $54.95 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $134.90 Typical High $245.47 | Facility | None | $109.65 | $134.90 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $147.91 | Professional | None | $57.54 | $61.66 | $147.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $45.71 Typical High $61.66 | Professional | UE · Used equipment | $42.66 | $45.71 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $85.11 Typical High $114.82 | Facility | None | $57.54 | $85.11 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $154.88 | Professional | None | $74.13 | $102.33 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $131.83 | Professional | None | $70.79 | $97.72 | $131.83 |
SummaCare Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $181.97 | Professional | None | $114.82 | $117.49 | $181.97 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $165.96 | Facility | None | $117.49 | $117.49 | $165.96 |
United Setting Professional Modifier None Typical Low $38.02 Median $56.23 Typical High $83.18 | Professional | None | $38.02 | $56.23 | $83.18 |
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 $27.54 Median $27.54 Typical High $77.62 | Professional | 52 · Reduced service | $27.54 | $27.54 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $30.90 | Professional | 53 · Discontinued | $11.22 | $11.22 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $22.91 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $15.49 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $15.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $6.61 | Professional | RR · Rental | $6.17 | $6.17 | $6.61 |
Where Ohio sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 43rd of 51
$66.07
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.