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 $323.59 Median $323.59 Typical High $1,479.11 | Facility | None | $323.59 | $323.59 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $1,023.29 | Professional | None | $323.59 | $323.59 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $1,445.44 | Facility | None | $630.96 | $794.33 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $851.14 | Professional | None | $331.13 | $363.08 | $851.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $251.19 Median $269.15 Typical High $354.81 | Professional | UE · Used equipment | $251.19 | $269.15 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $446.68 Typical High $588.84 | Facility | None | $295.12 | $446.68 | $588.84 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $794.33 | Professional | None | $389.05 | $537.03 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Molina Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $524.81 | Professional | None | $281.84 | $389.05 | $524.81 |
SummaCare Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $1,071.52 | Professional | None | $676.08 | $691.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $812.83 | Facility | None | $398.11 | $398.11 | $812.83 |
United Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $478.63 | Professional | None | $223.87 | $331.13 | $478.63 |
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 $162.18 Median $162.18 Typical High $512.86 | Professional | 52 · Reduced service | $162.18 | $162.18 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $204.17 | Professional | 53 · Discontinued | $64.57 | $64.57 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $154.88 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $102.33 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $102.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $36.31 Median $36.31 Typical High $38.90 | Professional | RR · Rental | $36.31 | $36.31 | $38.90 |
Where Ohio sits
The same service costs 3.7 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· 39th of 51
$355
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.