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 $204.17 Median $204.17 Typical High $741.31 | Facility | None | $204.17 | $204.17 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $691.83 | Professional | None | $204.17 | $204.17 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $457.09 Typical High $831.76 | Facility | None | $371.54 | $457.09 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $489.78 | Professional | None | $169.82 | $186.21 | $489.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $141.25 Typical High $194.98 | Professional | UE · Used equipment | $131.83 | $141.25 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $229.09 Typical High $309.03 | Facility | None | $154.88 | $229.09 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $416.87 | Professional | None | $199.53 | $275.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None | $165.96 | $165.96 | $223.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | None | $165.96 | $165.96 | $223.87 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $302.00 | Professional | None | $162.18 | $223.87 | $302.00 |
SummaCare Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $616.60 | Professional | None | $389.05 | $398.11 | $616.60 |
United Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $389.05 | Facility | None | $190.55 | $208.93 | $389.05 |
United Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $275.42 | Professional | None | $109.65 | $181.97 | $275.42 |
5 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 $102.33 Median $102.33 Typical High $346.74 | Professional | 52 · Reduced service | $102.33 | $102.33 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $138.04 | Professional | 53 · Discontinued | $41.69 | $41.69 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $102.33 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $69.18 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $69.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | RR · Rental | $17.38 | $17.38 | $19.05 |
Where Ohio sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 27th of 51
$186
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.