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 $302.00 Median $302.00 Typical High $1,548.82 | Facility | None | $302.00 | $302.00 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,071.52 | Professional | None | $302.00 | $302.00 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $741.31 Typical High $1,348.96 | Facility | None | $602.56 | $741.31 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $676.08 | Professional | None | $302.00 | $457.09 | $676.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $257.04 Typical High $346.74 | Professional | UE · Used equipment | $229.09 | $257.04 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $575.44 Typical High $776.25 | Facility | None | $389.05 | $575.44 | $776.25 |
CareSource Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $1,047.13 | Professional | None | $501.19 | $691.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $489.78 | Professional | None | $263.03 | $363.08 | $489.78 |
SummaCare Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $1,000.00 | Professional | None | $630.96 | $645.65 | $1,000.00 |
United Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $851.14 | Facility | None | $281.84 | $331.13 | $851.14 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $478.63 | Professional | None | $208.93 | $309.03 | $478.63 |
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 $151.36 Median $151.36 Typical High $537.03 | Professional | 52 · Reduced service | $151.36 | $151.36 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $213.80 | Professional | 53 · Discontinued | $60.26 | $60.26 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $162.18 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $107.15 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | RR · Rental | $45.71 | $45.71 | $48.98 |
Where Ohio sits
The same service costs 2.6 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· 41st 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.