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 $208.93 Median $208.93 Typical High $1,148.15 | Facility | None | $208.93 | $208.93 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $794.33 | Professional | None | $208.93 | $208.93 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $512.86 Typical High $933.25 | Facility | None | $416.87 | $512.86 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $562.34 | Professional | None | $213.80 | $269.15 | $562.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $181.97 Typical High $239.88 | Professional | UE · Used equipment | $162.18 | $181.97 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $446.68 | Facility | None | $223.87 | $338.84 | $446.68 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $602.56 | Professional | None | $295.12 | $407.38 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | None | $204.17 | $204.17 | $281.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | None | $204.17 | $204.17 | $281.84 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $338.84 | Professional | None | $181.97 | $251.19 | $338.84 |
SummaCare Setting Professional Modifier None Typical Low $436.52 Median $446.68 Typical High $691.83 | Professional | None | $436.52 | $446.68 | $691.83 |
United Setting Facility Modifier None Typical Low $288.40 Median $389.05 Typical High $588.84 | Facility | None | $288.40 | $389.05 | $588.84 |
United Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $331.13 | Professional | None | $144.54 | $213.80 | $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 $104.71 Median $104.71 Typical High $398.11 | Professional | 52 · Reduced service | $104.71 | $104.71 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $158.49 | Professional | 53 · Discontinued | $41.69 | $41.69 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $120.23 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $79.43 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $79.43 |
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 4.1 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· 44th of 51
$234
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.