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 $190.55 Median $190.55 Typical High $891.25 | Facility | None | $190.55 | $190.55 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $831.76 | Professional | None | $190.55 | $190.55 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $275.42 Typical High $436.52 | Facility | None | $239.88 | $275.42 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | None | $112.20 | $112.20 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | UE · Used equipment | $85.11 | $85.11 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
SummaCare Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $524.81 | Professional | None | $223.87 | $263.03 | $524.81 |
United Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $331.13 | Professional | None | $100.00 | $173.78 | $331.13 |
2 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 $28.84 Median $28.84 Typical High $125.89 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $83.18 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $83.18 |
Where Ohio sits
The same service costs 3.3 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· 50th of 51
$112
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.