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 $501.19 Median $1,380.38 Typical High $1,698.24 | Facility | None | $501.19 | $1,380.38 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,230.27 | Professional | None | $501.19 | $501.19 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $1,096.48 Typical High $2,041.74 | Facility | None | $891.25 | $1,096.48 | $2,041.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $1,047.13 | Professional | None | $457.09 | $489.78 | $1,047.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $338.84 Median $363.08 Typical High $489.78 | Professional | UE · Used equipment | $338.84 | $363.08 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $645.65 Typical High $870.96 | Facility | None | $426.58 | $645.65 | $870.96 |
CareSource Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,174.90 | Professional | None | $562.34 | $776.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $724.44 | Professional | None | $398.11 | $537.03 | $724.44 |
SummaCare Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,513.56 | Professional | None | $954.99 | $954.99 | $1,513.56 |
United Setting Facility Modifier None Typical Low $537.03 Median $562.34 Typical High $1,096.48 | Facility | None | $537.03 | $562.34 | $1,096.48 |
United Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $676.08 | Professional | None | $309.03 | $446.68 | $676.08 |
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 $251.19 Median $251.19 Typical High $616.60 | Professional | 52 · Reduced service | $251.19 | $251.19 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $245.47 | Professional | 53 · Discontinued | $100.00 | $100.00 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $181.97 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $123.03 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $123.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $48.98 Typical High $64.57 | Professional | RR · Rental | $48.98 | $48.98 | $64.57 |
Where Ohio sits
The same service costs 3.9 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
$490
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.