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 $269.15 Median $269.15 Typical High $1,047.13 | Facility | None | $269.15 | $269.15 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $724.44 | Professional | None | $269.15 | $269.15 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $645.65 Typical High $1,202.26 | Facility | None | $524.81 | $645.65 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $707.95 | Professional | None | $263.03 | $275.42 | $707.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $204.17 Typical High $288.40 | Professional | UE · Used equipment | $199.53 | $204.17 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $436.52 | Facility | None | $218.78 | $323.59 | $436.52 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $588.84 | Professional | None | $281.84 | $389.05 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $436.52 | Professional | None | $234.42 | $316.23 | $436.52 |
SummaCare Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $891.25 | Professional | None | $562.34 | $562.34 | $891.25 |
United Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $588.84 | Facility | None | $165.96 | $223.87 | $588.84 |
United Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $398.11 | Professional | None | $181.97 | $275.42 | $398.11 |
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 $134.90 Median $134.90 Typical High $363.08 | Professional | 52 · Reduced service | $134.90 | $134.90 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $144.54 | Professional | 53 · Discontinued | $53.70 | $53.70 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $109.65 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $72.44 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $72.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $28.84 | Professional | RR · Rental | $26.92 | $26.92 | $28.84 |
Where Ohio sits
The same service costs 2.2 times more in Wisconsin than in Pennsylvania. 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
$275
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.