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 $436.52 Median $436.52 Typical High $1,548.82 | Facility | None | $436.52 | $436.52 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,445.44 | Professional | None | $436.52 | $436.52 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $954.99 Typical High $1,737.80 | Facility | None | $776.25 | $954.99 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $870.96 | Professional | None | $371.54 | $389.05 | $870.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $295.12 Typical High $416.87 | Professional | UE · Used equipment | $281.84 | $295.12 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $478.63 Typical High $645.65 | Facility | None | $323.59 | $478.63 | $645.65 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $870.96 | Professional | None | $416.87 | $575.44 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $630.96 | Professional | None | $338.84 | $467.74 | $630.96 |
SummaCare Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $1,288.25 | Professional | None | $812.83 | $831.76 | $1,288.25 |
United Setting Facility Modifier None Typical Low $295.12 Median $331.13 Typical High $870.96 | Facility | None | $295.12 | $331.13 | $870.96 |
United Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $575.44 | Professional | None | $245.47 | $380.19 | $575.44 |
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 $213.80 Median $213.80 Typical High $724.44 | Professional | 52 · Reduced service | $213.80 | $213.80 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $288.40 | Professional | 53 · Discontinued | $87.10 | $87.10 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $213.80 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $144.54 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $144.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $37.15 Median $37.15 Typical High $51.29 | Professional | RR · Rental | $37.15 | $37.15 | $51.29 |
Where Ohio sits
The same service costs 3.0 times more in Montana than in Florida. 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· 32nd of 51
$389
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.