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 $426.58 Median $426.58 Typical High $1,548.82 | Facility | None | $426.58 | $426.58 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,445.44 | Professional | None | $426.58 | $426.58 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $933.25 Typical High $1,737.80 | Facility | None | $758.58 | $933.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $1,023.29 | Professional | None | $389.05 | $478.63 | $1,023.29 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $707.95 Typical High $954.99 | Facility | None | $467.74 | $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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Molina Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,174.90 | Professional | None | $630.96 | $870.96 | $1,174.90 |
SummaCare Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,288.25 | Professional | None | $812.83 | $812.83 | $1,288.25 |
United Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $1,071.52 | Facility | None | $478.63 | $524.81 | $1,071.52 |
United Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $575.44 | Professional | None | $263.03 | $398.11 | $575.44 |
6 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 $213.80 Median $213.80 Typical High $724.44 | Professional | 52 · Reduced service | $213.80 | $213.80 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $288.40 | Professional | 53 · Discontinued | $85.11 | $85.11 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $218.78 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $144.54 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $144.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | RR · Rental | $47.86 | $47.86 | $52.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | UE · Used equipment | $363.08 | $363.08 | $389.05 |
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· 42nd 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.