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 $354.81 Median $354.81 Typical High $1,737.80 | Facility | None | $354.81 | $354.81 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $1,202.26 | Professional | None | $354.81 | $354.81 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $1,584.89 | Facility | None | $691.83 | $851.14 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $933.25 | Professional | None | $363.08 | $380.19 | $933.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $288.40 Typical High $380.19 | Professional | UE · Used equipment | $269.15 | $288.40 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $467.74 Typical High $630.96 | Facility | None | $316.23 | $467.74 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $851.14 | Professional | None | $407.38 | $562.34 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $467.74 | Professional | None | $338.84 | $338.84 | $467.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $467.74 | Professional | None | $338.84 | $338.84 | $467.74 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $575.44 | Professional | None | $309.03 | $426.58 | $575.44 |
SummaCare Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $1,174.90 | Professional | None | $741.31 | $758.58 | $1,174.90 |
United Setting Facility Modifier None Typical Low $380.19 Median $416.87 Typical High $851.14 | Facility | None | $380.19 | $416.87 | $851.14 |
United Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $524.81 | Professional | None | $239.88 | $363.08 | $524.81 |
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 $177.83 Median $177.83 Typical High $602.56 | Professional | 52 · Reduced service | $177.83 | $177.83 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $239.88 | Professional | 53 · Discontinued | $70.79 | $70.79 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $181.97 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $120.23 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $120.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $41.69 | Professional | RR · Rental | $38.02 | $38.02 | $41.69 |
Where Ohio sits
The same service costs 2.9 times more in Hawaii than in Florida. 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· 34th of 51
$380
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.