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 $194.98 Median $194.98 Typical High $870.96 | Facility | None | $194.98 | $194.98 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $602.56 | Professional | None | $194.98 | $194.98 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $478.63 Typical High $870.96 | Facility | None | $389.05 | $478.63 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $524.81 | Professional | None | $194.98 | $218.78 | $524.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $162.18 Typical High $208.93 | Professional | UE · Used equipment | $147.91 | $162.18 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $269.15 Typical High $363.08 | Facility | None | $177.83 | $269.15 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $489.78 | Professional | None | $234.42 | $323.59 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $316.23 | Professional | None | $169.82 | $234.42 | $316.23 |
SummaCare Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $645.65 | Professional | None | $407.38 | $416.87 | $645.65 |
United Setting Facility Modifier None Typical Low $158.49 Median $173.78 Typical High $457.09 | Facility | None | $158.49 | $173.78 | $457.09 |
United Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $295.12 | Professional | None | $134.90 | $199.53 | $295.12 |
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 $97.72 Median $97.72 Typical High $302.00 | Professional | 52 · Reduced service | $97.72 | $97.72 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $120.23 | Professional | 53 · Discontinued | $39.81 | $39.81 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $89.13 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $60.26 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.38 Median $21.38 Typical High $23.44 | Professional | RR · Rental | $21.38 | $21.38 | $23.44 |
Where Ohio sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 38th of 51
$214
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.