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 $398.11 Median $398.11 Typical High $1,348.96 | Facility | None | $398.11 | $398.11 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $1,258.93 | Professional | None | $398.11 | $398.11 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $1,621.81 | Facility | None | $724.44 | $891.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $831.76 | Professional | None | $363.08 | $467.74 | $831.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $275.42 Median $309.03 Typical High $398.11 | Professional | UE · Used equipment | $275.42 | $309.03 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $602.56 Typical High $794.33 | Facility | None | $398.11 | $602.56 | $794.33 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,071.52 | Professional | None | $512.86 | $724.44 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $588.84 | Professional | None | $316.23 | $436.52 | $588.84 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,202.26 | Professional | None | $758.58 | $776.25 | $1,202.26 |
United Setting Facility Modifier None Typical Low $478.63 Median $630.96 Typical High $977.24 | Facility | None | $478.63 | $630.96 | $977.24 |
United Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $537.03 | Professional | None | $251.19 | $363.08 | $537.03 |
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 $199.53 Median $199.53 Typical High $630.96 | Professional | 52 · Reduced service | $199.53 | $199.53 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $251.19 | Professional | 53 · Discontinued | $81.28 | $81.28 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $186.21 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $125.89 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $125.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $46.77 Median $46.77 Typical High $50.12 | Professional | RR · Rental | $46.77 | $46.77 | $50.12 |
Where Ohio sits
The same service costs 4.6 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
$437
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.