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 $630.96 Median $630.96 Typical High $1,548.82 | Facility | None | $630.96 | $630.96 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,412.54 | Professional | None | $630.96 | $630.96 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,511.89 | Facility | None | $1,122.02 | $1,380.38 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $1,513.56 | Professional | None | $562.34 | $588.84 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $776.25 Typical High $1,023.29 | Facility | None | $512.86 | $776.25 | $1,023.29 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,380.38 | Professional | None | $676.08 | $933.25 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
Molina Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $912.01 | Professional | None | $489.78 | $676.08 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,202.26 | $1,862.09 |
United Setting Facility Modifier None Typical Low $575.44 Median $645.65 Typical High $1,318.26 | Facility | None | $575.44 | $645.65 | $1,318.26 |
United Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $831.76 | Professional | None | $371.54 | $549.54 | $831.76 |
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 $309.03 Median $309.03 Typical High $707.95 | Professional | 52 · Reduced service | $309.03 | $309.03 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $288.40 | Professional | 53 · Discontinued | $125.89 | $125.89 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $213.80 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $141.25 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $141.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | RR · Rental | $58.88 | $58.88 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $446.68 Median $446.68 Typical High $524.81 | Professional | UE · Used equipment | $446.68 | $446.68 | $524.81 |
Where Ohio sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 34th of 51
$589
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.