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 $562.34 Median $562.34 Typical High $1,949.84 | Facility | None | $562.34 | $562.34 | $1,949.84 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,819.70 | Professional | None | $562.34 | $562.34 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $2,290.87 | Facility | None | $1,000.00 | $1,230.27 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $1,348.96 | Professional | None | $512.86 | $630.96 | $1,348.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $389.05 Median $426.58 Typical High $562.34 | Professional | UE · Used equipment | $389.05 | $426.58 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $776.25 Typical High $1,047.13 | Facility | None | $524.81 | $776.25 | $1,047.13 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,412.54 | Professional | None | $676.08 | $933.25 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $831.76 | Professional | None | $446.68 | $616.60 | $831.76 |
SummaCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,096.48 | $1,698.24 |
United Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,412.54 | Facility | None | $691.83 | $933.25 | $1,412.54 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $776.25 | Professional | None | $346.74 | $524.81 | $776.25 |
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 $281.84 Median $281.84 Typical High $912.01 | Professional | 52 · Reduced service | $281.84 | $281.84 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $363.08 | Professional | 53 · Discontinued | $112.20 | $112.20 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $275.42 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $181.97 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | RR · Rental | $63.10 | $63.10 | $67.61 |
Where Ohio sits
The same service costs 4.2 times more in Hawaii 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· 45th of 51
$562
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.