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 $269.15 Median $269.15 Typical High $1,621.81 | Facility | None | $269.15 | $269.15 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $1,513.56 | Professional | None | $269.15 | $269.15 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $588.84 Typical High $1,096.48 | Facility | None | $478.63 | $588.84 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $645.65 | Professional | None | $245.47 | $281.84 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $346.74 Typical High $457.09 | Facility | None | $229.09 | $346.74 | $457.09 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $616.60 | Professional | None | $302.00 | $416.87 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $354.81 | Professional | None | $257.04 | $257.04 | $354.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $354.81 | Professional | None | $257.04 | $257.04 | $354.81 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $398.11 | Professional | None | $213.80 | $295.12 | $398.11 |
SummaCare Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $812.83 | Professional | None | $512.86 | $512.86 | $812.83 |
United Setting Facility Modifier None Typical Low $234.42 Median $309.03 Typical High $630.96 | Facility | None | $234.42 | $309.03 | $630.96 |
United Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $363.08 | Professional | None | $165.96 | $239.88 | $363.08 |
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 $134.90 Median $134.90 Typical High $758.58 | Professional | 52 · Reduced service | $134.90 | $134.90 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $302.00 | Professional | 53 · Discontinued | $53.70 | $53.70 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $223.87 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $151.36 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $151.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $28.18 Typical High $35.48 | Professional | RR · Rental | $28.18 | $28.18 | $35.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | UE · Used equipment | $208.93 | $208.93 | $208.93 |
Where Ohio sits
The same service costs 3.5 times more in Hawaii than in Florida. 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
$269
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.