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 $257.04 Median $257.04 Typical High $1,202.26 | Facility | None | $257.04 | $257.04 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $831.76 | Professional | None | $257.04 | $257.04 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $630.96 Typical High $1,148.15 | Facility | None | $512.86 | $630.96 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $691.83 | Professional | None | $269.15 | $302.00 | $691.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $223.87 Typical High $295.12 | Professional | UE · Used equipment | $199.53 | $223.87 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $380.19 Typical High $501.19 | Facility | None | $251.19 | $380.19 | $501.19 |
CareSource Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $676.08 | Professional | None | $323.59 | $446.68 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $416.87 | Professional | None | $223.87 | $309.03 | $416.87 |
SummaCare Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $851.14 | Professional | None | $537.03 | $549.54 | $851.14 |
United Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $676.08 | Facility | None | $173.78 | $251.19 | $676.08 |
United Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $389.05 | Professional | None | $177.83 | $263.03 | $389.05 |
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 $128.82 Median $128.82 Typical High $416.87 | Professional | 52 · Reduced service | $128.82 | $128.82 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $165.96 | Professional | 53 · Discontinued | $52.48 | $52.48 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $125.89 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $83.18 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $33.11 | Professional | RR · Rental | $30.20 | $30.20 | $33.11 |
Where Ohio sits
The same service costs 2.9 times more in Iowa than in Kansas. 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· 44th of 51
$288
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.