How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $75.86 Median $75.86 Typical High $1,202.26 | Facility | None | $75.86 | $75.86 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $758.58 | Professional | None | $75.86 | $75.86 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $70.79 | Professional | None | $34.67 | $47.86 | $70.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.90 Median $36.31 Typical High $52.48 | Professional | UE · Used equipment | $30.90 | $36.31 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $60.26 | Professional | None | $30.20 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
3 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 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $114.82 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $75.86 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | RR · Rental | $18.62 | $18.62 | $18.62 |
Where Ohio sits
The same service costs 17.0 times more in North Carolina than in Ohio. 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· 51st of 51
$52.48
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.