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 $575.44 | Facility | None | $120.23 | $120.23 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $537.03 | Professional | None | $120.23 | $120.23 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $269.15 Typical High $489.78 | Facility | None | $218.78 | $269.15 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $302.00 | Professional | None | $165.96 | $199.53 | $302.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $125.89 Median $138.04 Typical High $181.97 | Professional | UE · Used equipment | $125.89 | $138.04 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $245.47 | Facility | None | $123.03 | $181.97 | $245.47 |
CareSource Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $331.13 | Professional | None | $158.49 | $218.78 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
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 $302.00 Median $316.23 Typical High $478.63 | Professional | None | $302.00 | $316.23 | $478.63 |
United Setting Facility Modifier None Typical Low $213.80 Median $234.42 Typical High $407.38 | Facility | None | $213.80 | $234.42 | $407.38 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $234.42 | Professional | None | $107.15 | $162.18 | $234.42 |
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 $60.26 Median $60.26 Typical High $269.15 | Professional | 52 · Reduced service | $60.26 | $60.26 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $107.15 | Professional | 53 · Discontinued | $23.99 | $23.99 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $79.43 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $53.70 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | RR · Rental | $19.95 | $19.95 | $20.42 |
Where Ohio sits
The same service costs 2.9 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· 41st of 51
$170
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.