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 $309.03 Median $309.03 Typical High $1,000.00 | Facility | None | $309.03 | $309.03 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $933.25 | Professional | None | $309.03 | $309.03 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $1,258.93 | Facility | None | $549.54 | $676.08 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $741.31 | Professional | None | $281.84 | $338.84 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $489.78 Typical High $660.69 | Facility | None | $331.13 | $489.78 | $660.69 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $891.25 | Professional | None | $426.58 | $588.84 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $457.09 | Professional | None | $245.47 | $338.84 | $457.09 |
SummaCare Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $933.25 | Professional | None | $588.84 | $602.56 | $933.25 |
United Setting Facility Modifier None Typical Low $269.15 Median $371.54 Typical High $758.58 | Facility | None | $269.15 | $371.54 | $758.58 |
United Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $416.87 | Professional | None | $190.55 | $281.84 | $416.87 |
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 $154.88 Median $154.88 Typical High $467.74 | Professional | 52 · Reduced service | $154.88 | $154.88 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $186.21 | Professional | 53 · Discontinued | $61.66 | $61.66 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $141.25 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $93.33 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | RR · Rental | $33.88 | $33.88 | $44.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | UE · Used equipment | $257.04 | $257.04 | $257.04 |
Where Ohio sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 40th of 51
$309
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.