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 $776.25 Median $776.25 Typical High $3,630.78 | Facility | None | $776.25 | $776.25 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $2,511.89 | Professional | None | $776.25 | $776.25 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $3,467.37 | Facility | None | $1,513.56 | $1,862.09 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,778.28 | Professional | None | $794.33 | $954.99 | $1,778.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $602.56 Median $660.69 Typical High $831.76 | Professional | UE · Used equipment | $602.56 | $660.69 | $831.76 |
Aultcare Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,584.89 | Facility | None | $794.33 | $1,202.26 | $1,584.89 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,445.44 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $954.99 | Professional | None | $691.83 | $691.83 | $954.99 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $954.99 | Professional | None | $691.83 | $691.83 | $954.99 |
Molina Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,513.56 | Professional | None | $831.76 | $1,122.02 | $1,513.56 |
SummaCare Setting Professional Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,621.81 | $1,659.59 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,290.87 | Facility | None | $1,621.81 | $1,621.81 | $2,290.87 |
United Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,148.15 | Professional | None | $524.81 | $794.33 | $1,148.15 |
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 $389.05 Median $389.05 Typical High $1,258.93 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $501.19 | Professional | 53 · Discontinued | $154.88 | $154.88 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $371.54 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $251.19 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $251.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | RR · Rental | $95.50 | $95.50 | $102.33 |
Where Ohio sits
The same service costs 2.4 times more in Montana 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· 32nd of 51
$955
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.