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 $407.38 Median $407.38 Typical High $1,230.27 | Facility | None | $407.38 | $407.38 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $1,122.02 | Professional | None | $407.38 | $407.38 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $1,659.59 | Facility | None | $724.44 | $891.25 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $977.24 | Professional | None | $363.08 | $398.11 | $977.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $275.42 Median $288.40 Typical High $389.05 | Professional | UE · Used equipment | $275.42 | $288.40 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $489.78 Typical High $660.69 | Facility | None | $323.59 | $489.78 | $660.69 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $891.25 | Professional | None | $426.58 | $588.84 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $602.56 | Professional | None | $323.59 | $446.68 | $602.56 |
SummaCare Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,230.27 | Professional | None | $776.25 | $794.33 | $1,230.27 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $891.25 | Facility | None | $436.52 | $436.52 | $891.25 |
United Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $549.54 | Professional | None | $251.19 | $363.08 | $549.54 |
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 $204.17 Median $204.17 Typical High $562.34 | Professional | 52 · Reduced service | $204.17 | $204.17 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $223.87 | Professional | 53 · Discontinued | $81.28 | $81.28 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $169.82 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $112.20 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $112.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | RR · Rental | $38.02 | $38.02 | $39.81 |
Where Ohio sits
The same service costs 3.5 times more in Hawaii 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· 37th of 51
$398
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.