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 $524.81 Median $524.81 Typical High $1,737.80 | Facility | None | $524.81 | $524.81 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,621.81 | Professional | None | $524.81 | $524.81 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $1,148.15 Typical High $2,137.96 | Facility | None | $933.25 | $1,148.15 | $2,137.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $1,071.52 | Professional | None | $478.63 | $489.78 | $1,071.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $354.81 Median $363.08 Typical High $512.86 | Professional | UE · Used equipment | $354.81 | $363.08 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $954.99 | Facility | None | $478.63 | $707.95 | $954.99 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,288.25 | Professional | None | $616.60 | $851.14 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | None | $371.54 | $371.54 | $512.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | None | $371.54 | $371.54 | $512.86 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $758.58 | Professional | None | $416.87 | $562.34 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,000.00 | $1,548.82 |
United Setting Facility Modifier None Typical Low $478.63 Median $549.54 Typical High $1,122.02 | Facility | None | $478.63 | $549.54 | $1,122.02 |
United Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $707.95 | Professional | None | $316.23 | $457.09 | $707.95 |
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 $263.03 Median $263.03 Typical High $812.83 | Professional | 52 · Reduced service | $263.03 | $263.03 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $323.59 | Professional | 53 · Discontinued | $104.71 | $104.71 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $245.47 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $162.18 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $162.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | RR · Rental | $48.98 | $48.98 | $66.07 |
Where Ohio sits
The same service costs 3.2 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· 35th 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.