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 $120.23 Median $120.23 Typical High $676.08 | Facility | None | $120.23 | $120.23 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $630.96 | Professional | None | $120.23 | $120.23 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $263.03 Typical High $489.78 | Facility | None | $213.80 | $263.03 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $331.13 | Professional | None | $194.98 | $234.42 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $194.98 Typical High $263.03 | Facility | None | $131.83 | $194.98 | $263.03 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $354.81 | Professional | None | $169.82 | $234.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $269.15 | Professional | None | $144.54 | $199.53 | $269.15 |
SummaCare Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $549.54 | Professional | None | $346.74 | $363.08 | $549.54 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $501.19 | Facility | None | $354.81 | $354.81 | $501.19 |
United Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $275.42 | Professional | None | $123.03 | $194.98 | $275.42 |
6 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 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $316.23 | Professional | 52 · Reduced service | $58.88 | $58.88 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $125.89 | Professional | 53 · Discontinued | $23.99 | $23.99 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $95.50 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $63.10 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $63.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $23.99 Typical High $25.70 | Professional | RR · Rental | $23.99 | $23.99 | $25.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | UE · Used equipment | $177.83 | $177.83 | $177.83 |
Where Ohio sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 43rd of 51
$204
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.