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 $181.97 Typical High $1,659.59 | Facility | None | $181.97 | $181.97 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $1,148.15 | Professional | None | $181.97 | $181.97 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $501.19 | Professional | None | $158.49 | $186.21 | $501.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $141.25 Median $141.25 Typical High $208.93 | Professional | UE · Used equipment | $141.25 | $141.25 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $269.15 Typical High $363.08 | Facility | None | $181.97 | $269.15 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $489.78 | Professional | None | $234.42 | $323.59 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $436.52 | Professional | None | $234.42 | $323.59 | $436.52 |
SummaCare Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $602.56 | Professional | None | $380.19 | $389.05 | $602.56 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $269.15 | Professional | None | $125.89 | $186.21 | $269.15 |
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 $91.20 Median $91.20 Typical High $575.44 | Professional | 52 · Reduced service | $91.20 | $91.20 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $229.09 | Professional | 53 · Discontinued | $36.31 | $36.31 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $169.82 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $114.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $30.20 | Professional | RR · Rental | $26.92 | $26.92 | $30.20 |
Where Ohio sits
The same service costs 3.0 times more in Iowa than in New York. 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· 44th of 51
$224
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.