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 $371.54 Median $371.54 Typical High $1,318.26 | Facility | None | $371.54 | $371.54 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $1,230.27 | Professional | None | $371.54 | $371.54 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $812.83 Typical High $1,513.56 | Facility | None | $660.69 | $812.83 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $912.01 | Professional | None | $323.59 | $389.05 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $524.81 Typical High $691.83 | Facility | None | $346.74 | $524.81 | $691.83 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $933.25 | Professional | None | $457.09 | $630.96 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $616.60 | Professional | None | $331.13 | $457.09 | $616.60 |
SummaCare Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,122.02 | Professional | None | $707.95 | $741.31 | $1,122.02 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $1,000.00 | Facility | None | $707.95 | $707.95 | $1,000.00 |
United Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $501.19 | Professional | None | $229.09 | $331.13 | $501.19 |
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 $186.21 Median $186.21 Typical High $616.60 | Professional | 52 · Reduced service | $186.21 | $186.21 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $245.47 | Professional | 53 · Discontinued | $74.13 | $74.13 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $181.97 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $123.03 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $123.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $42.66 | Professional | RR · Rental | $38.90 | $38.90 | $42.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $316.23 | Professional | UE · Used equipment | $295.12 | $295.12 | $316.23 |
Where Ohio sits
The same service costs 2.3 times more in Montana than in Delaware. 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· 40th of 51
$372
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.