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 $295.12 Median $295.12 Typical High $691.83 | Facility | None | $295.12 | $295.12 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $645.65 | Professional | None | $295.12 | $295.12 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $645.65 Typical High $1,202.26 | Facility | None | $524.81 | $645.65 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $707.95 | Professional | None | $251.19 | $295.12 | $707.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $218.78 Typical High $281.84 | Professional | UE · Used equipment | $199.53 | $218.78 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $354.81 Typical High $478.63 | Facility | None | $239.88 | $354.81 | $478.63 |
CareSource Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $645.65 | Professional | None | $309.03 | $426.58 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | None | $218.78 | $218.78 | $295.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | None | $218.78 | $218.78 | $295.12 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $426.58 | Professional | None | $234.42 | $316.23 | $426.58 |
SummaCare Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $891.25 | Professional | None | $562.34 | $562.34 | $891.25 |
United Setting Facility Modifier None Typical Low $316.23 Median $346.74 Typical High $645.65 | Facility | None | $316.23 | $346.74 | $645.65 |
United Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $398.11 | Professional | None | $181.97 | $263.03 | $398.11 |
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 $147.91 Median $147.91 Typical High $323.59 | Professional | 52 · Reduced service | $147.91 | $147.91 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $128.82 | Professional | 53 · Discontinued | $58.88 | $58.88 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $97.72 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $64.57 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $64.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | RR · Rental | $28.84 | $28.84 | $38.02 |
Where Ohio sits
The same service costs 4.2 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· 27th of 51
$295
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.