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 $8.32 Median $8.32 Typical High $83.18 | Facility | None | $8.32 | $8.32 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $83.18 | Professional | None | $8.32 | $8.32 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.47 Median $12.02 Typical High $19.05 | Facility | None | $10.47 | $12.02 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $5.75 Typical High $16.98 | Professional | None | $2.88 | $5.75 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.39 Typical High $3.98 | Professional | UE · Used equipment | $3.02 | $3.39 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
SummaCare Setting Professional Modifier None Typical Low $9.77 Median $11.48 Typical High $22.91 | Professional | None | $9.77 | $11.48 | $22.91 |
United Setting Professional Modifier None Typical Low $4.37 Median $7.59 Typical High $14.45 | Professional | None | $4.37 | $7.59 | $14.45 |
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 $1.26 Median $1.26 Typical High $12.59 | Professional | 55 · Aftercare only | $1.26 | $1.26 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.83 Typical High $8.32 | Professional | 56 · Pre-op care only | $0.83 | $0.83 | $8.32 |
Where Ohio sits
The same service costs 4.7 times more in Florida 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· 35th of 51
$8.91
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.