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 $660.69 Median $660.69 Typical High $2,691.53 | Facility | None | $660.69 | $660.69 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,862.09 | Professional | None | $660.69 | $660.69 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,951.21 | Facility | None | $1,288.25 | $1,584.89 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $1,737.80 | Professional | None | $645.65 | $676.08 | $1,737.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $489.78 Median $512.86 Typical High $707.95 | Professional | UE · Used equipment | $489.78 | $512.86 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $870.96 Typical High $1,148.15 | Facility | None | $575.44 | $870.96 | $1,148.15 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,548.82 | Professional | None | $758.58 | $1,047.13 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
Molina Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,071.52 | Professional | None | $575.44 | $794.33 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,412.54 | $2,187.76 |
United Setting Facility Modifier None Typical Low $616.60 Median $645.65 Typical High $1,479.11 | Facility | None | $616.60 | $645.65 | $1,479.11 |
United Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $977.24 | Professional | None | $446.68 | $676.08 | $977.24 |
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 $331.13 Median $331.13 Typical High $933.25 | Professional | 52 · Reduced service | $331.13 | $331.13 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $371.54 | Professional | 53 · Discontinued | $131.83 | $131.83 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $281.84 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $186.21 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $186.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $70.79 | Professional | RR · Rental | $66.07 | $66.07 | $70.79 |
Where Ohio sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 30th of 51
$676
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.