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 $1.26 Median $1.26 Typical High $1,174.90 | Facility | None | $1.26 | $1.26 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $741.31 | Professional | None | $1.26 | $1.26 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $131.83 | Professional | None | $64.57 | $89.13 | $131.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $57.54 Median $67.61 Typical High $95.50 | Professional | UE · Used equipment | $57.54 | $67.61 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $0.19 Median $0.19 Typical High $112.20 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $74.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | RR · Rental | $30.20 | $30.20 | $30.20 |
Where Ohio sits
The same service costs 478.6 times more in North Carolina than in Alabama. 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· 28th of 51
$89.13
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.