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 $213.80 Median $213.80 Typical High $1,071.52 | Facility | None | $213.80 | $213.80 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $758.58 | Professional | None | $213.80 | $213.80 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $512.86 Typical High $954.99 | Facility | None | $416.87 | $512.86 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $489.78 | Professional | None | $213.80 | $263.03 | $489.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $173.78 Typical High $223.87 | Professional | UE · Used equipment | $158.49 | $173.78 | $223.87 |
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 $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 $186.21 Median $251.19 Typical High $338.84 | Professional | None | $186.21 | $251.19 | $338.84 |
SummaCare Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $707.95 | Professional | None | $446.68 | $446.68 | $707.95 |
United Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $588.84 | Facility | None | $281.84 | $288.40 | $588.84 |
United Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $331.13 | Professional | None | $144.54 | $218.78 | $331.13 |
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 $107.15 Median $107.15 Typical High $371.54 | Professional | 52 · Reduced service | $107.15 | $107.15 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $151.36 | Professional | 53 · Discontinued | $42.66 | $42.66 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $112.20 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $75.86 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.30 Median $26.30 Typical High $28.18 | Professional | RR · Rental | $26.30 | $26.30 | $28.18 |
Where Ohio sits
The same service costs 3.3 times more in Hawaii than in Delaware. 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
$263
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.