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 $181.97 Median $181.97 Typical High $616.60 | Facility | None | $181.97 | $181.97 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $575.44 | Professional | None | $181.97 | $181.97 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $398.11 Typical High $741.31 | Facility | None | $323.59 | $398.11 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $436.52 | Professional | None | $162.18 | $181.97 | $436.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $138.04 Typical High $177.83 | Professional | UE · Used equipment | $123.03 | $138.04 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $223.87 Typical High $302.00 | Facility | None | $151.36 | $223.87 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $407.38 | Professional | None | $194.98 | $269.15 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $457.09 | Professional | None | $245.47 | $338.84 | $457.09 |
SummaCare Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $549.54 | Professional | None | $346.74 | $346.74 | $549.54 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $407.38 | Facility | None | $199.53 | $204.17 | $407.38 |
United Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $245.47 | Professional | None | $112.20 | $162.18 | $245.47 |
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 $91.20 Median $91.20 Typical High $288.40 | Professional | 52 · Reduced service | $91.20 | $91.20 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $114.82 | Professional | 53 · Discontinued | $36.31 | $36.31 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $87.10 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $57.54 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $19.95 | Professional | RR · Rental | $18.20 | $18.20 | $19.95 |
Where Ohio sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 33rd of 51
$182
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.