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 $363.08 Median $363.08 Typical High $1,348.96 | Facility | None | $363.08 | $363.08 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $933.25 | Professional | None | $363.08 | $363.08 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $1,621.81 | Facility | None | $724.44 | $891.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $954.99 | Professional | None | $371.54 | $398.11 | $954.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $295.12 Typical High $389.05 | Professional | UE · Used equipment | $281.84 | $295.12 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $489.78 Typical High $660.69 | Facility | None | $323.59 | $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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $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 $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $630.96 | Professional | None | $338.84 | $467.74 | $630.96 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,202.26 | Professional | None | $758.58 | $776.25 | $1,202.26 |
United Setting Facility Modifier None Typical Low $165.96 Median $323.59 Typical High $891.25 | Facility | None | $165.96 | $323.59 | $891.25 |
United Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $537.03 | Professional | None | $251.19 | $371.54 | $537.03 |
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 $181.97 Median $181.97 Typical High $467.74 | Professional | 52 · Reduced service | $181.97 | $181.97 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $186.21 | Professional | 53 · Discontinued | $72.44 | $72.44 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $138.04 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $93.33 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $39.81 Typical High $42.66 | Professional | RR · Rental | $39.81 | $39.81 | $42.66 |
Where Ohio sits
The same service costs 2.4 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· 37th of 51
$398
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.