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 $323.59 Median $323.59 Typical High $977.24 | Facility | None | $323.59 | $323.59 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $912.01 | Professional | None | $323.59 | $323.59 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $707.95 Typical High $1,318.26 | Facility | None | $575.44 | $707.95 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $776.25 | Professional | None | $269.15 | $302.00 | $776.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $218.78 Median $223.87 Typical High $309.03 | Professional | UE · Used equipment | $218.78 | $223.87 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $537.03 | Facility | None | $263.03 | $398.11 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $724.44 | Professional | None | $346.74 | $478.63 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $776.25 | Professional | None | $416.87 | $575.44 | $776.25 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $954.99 | Professional | None | $616.60 | $616.60 | $954.99 |
United Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $676.08 | Facility | None | $331.13 | $426.58 | $676.08 |
United Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $436.52 | Professional | None | $190.55 | $281.84 | $436.52 |
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 $162.18 Median $162.18 Typical High $457.09 | Professional | 52 · Reduced service | $162.18 | $162.18 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $181.97 | Professional | 53 · Discontinued | $64.57 | $64.57 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $138.04 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $91.20 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $91.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $39.81 | Professional | RR · Rental | $30.20 | $30.20 | $39.81 |
Where Ohio sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 31st of 51
$302
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.