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 $380.19 Median $380.19 Typical High $1,348.96 | Facility | None | $380.19 | $380.19 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $933.25 | Professional | None | $380.19 | $380.19 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $912.01 Typical High $1,698.24 | Facility | None | $741.31 | $912.01 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $1,000.00 | Professional | None | $354.81 | $389.05 | $1,000.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $295.12 Typical High $407.38 | Professional | UE · Used equipment | $269.15 | $295.12 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $602.56 | Facility | None | $302.00 | $457.09 | $602.56 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $812.83 | Professional | None | $389.05 | $549.54 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $616.60 | Professional | None | $331.13 | $457.09 | $616.60 |
SummaCare Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,258.93 | Professional | None | $794.33 | $812.83 | $1,258.93 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $794.33 | Facility | None | $389.05 | $389.05 | $794.33 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $562.34 | Professional | None | $257.04 | $389.05 | $562.34 |
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 $190.55 Median $190.55 Typical High $467.74 | Professional | 52 · Reduced service | $190.55 | $190.55 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $186.21 | Professional | 53 · Discontinued | $75.86 | $75.86 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $141.25 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $93.33 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | RR · Rental | $35.48 | $35.48 | $38.90 |
Where Ohio sits
The same service costs 3.0 times more in Hawaii than in Washington, DC. 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· 31st of 51
$389
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.