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 $251.19 Median $251.19 Typical High $1,479.11 | Facility | None | $251.19 | $251.19 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $1,023.29 | Professional | None | $251.19 | $251.19 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $1,122.02 | Facility | None | $489.78 | $616.60 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $676.08 | Professional | None | $257.04 | $316.23 | $676.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $194.98 Median $218.78 Typical High $281.84 | Professional | UE · Used equipment | $194.98 | $218.78 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $524.81 | Facility | None | $263.03 | $398.11 | $524.81 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $707.95 | Professional | None | $338.84 | $467.74 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $407.38 | Professional | None | $218.78 | $302.00 | $407.38 |
SummaCare Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $831.76 | Professional | None | $524.81 | $537.03 | $831.76 |
United Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $707.95 | Facility | None | $346.74 | $416.87 | $707.95 |
United Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $398.11 | Professional | None | $173.78 | $257.04 | $398.11 |
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 $125.89 Median $125.89 Typical High $512.86 | Professional | 52 · Reduced service | $125.89 | $125.89 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $204.17 | Professional | 53 · Discontinued | $50.12 | $50.12 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $151.36 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $102.33 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $102.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | RR · Rental | $31.62 | $31.62 | $33.88 |
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· 45th of 51
$282
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.