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 $645.65 | Facility | None | $1.26 | $1.26 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $407.38 | Professional | None | $1.26 | $1.26 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $173.78 | Professional | None | $91.20 | $125.89 | $173.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $93.33 Typical High $131.83 | Professional | UE · Used equipment | $79.43 | $93.33 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $61.66 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $40.74 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | RR · Rental | $16.98 | $16.98 | $16.98 |
Where Ohio sits
The same service costs 676.1 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· 23rd of 51
$126
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.