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 $467.74 Median $467.74 Typical High $1,737.80 | Facility | None | $467.74 | $467.74 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,621.81 | Professional | None | $467.74 | $467.74 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,905.46 | Facility | None | $831.76 | $1,023.29 | $1,905.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $954.99 | Professional | None | $426.58 | $524.81 | $954.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $323.59 Median $354.81 Typical High $457.09 | Professional | UE · Used equipment | $323.59 | $354.81 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $812.83 Typical High $1,071.52 | Facility | None | $537.03 | $812.83 | $1,071.52 |
CareSource Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,445.44 | Professional | None | $691.83 | $977.24 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | None | $416.87 | $416.87 | $562.34 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | None | $416.87 | $416.87 | $562.34 |
Molina Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $691.83 | Professional | None | $371.54 | $512.86 | $691.83 |
SummaCare Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $1,412.54 | Professional | None | $891.25 | $912.01 | $1,412.54 |
United Setting Facility Modifier None Typical Low $549.54 Median $660.69 Typical High $1,202.26 | Facility | None | $549.54 | $660.69 | $1,202.26 |
United Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $660.69 | Professional | None | $288.40 | $436.52 | $660.69 |
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 $234.42 Median $234.42 Typical High $812.83 | Professional | 52 · Reduced service | $234.42 | $234.42 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $323.59 | Professional | 53 · Discontinued | $93.33 | $93.33 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $239.88 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $162.18 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $162.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | RR · Rental | $52.48 | $52.48 | $56.23 |
Where Ohio sits
The same service costs 3.6 times more in Hawaii than in Kansas. 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· 41st of 51
$513
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.