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 $436.52 Median $436.52 Typical High $2,511.89 | Facility | None | $436.52 | $436.52 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,737.80 | Professional | None | $436.52 | $436.52 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,949.84 | Facility | None | $870.96 | $1,071.52 | $1,949.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $1,000.00 | Professional | None | $446.68 | $524.81 | $1,000.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $338.84 Median $380.19 Typical High $489.78 | Professional | UE · Used equipment | $338.84 | $380.19 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $645.65 Typical High $870.96 | Facility | None | $426.58 | $645.65 | $870.96 |
CareSource Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,174.90 | Professional | None | $562.34 | $776.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Molina Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $707.95 | Professional | None | $380.19 | $524.81 | $707.95 |
SummaCare Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $1,445.44 | Professional | None | $912.01 | $933.25 | $1,445.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $524.81 Typical High $1,174.90 | Facility | None | $501.19 | $524.81 | $1,174.90 |
United Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $660.69 | Professional | None | $302.00 | $446.68 | $660.69 |
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 $218.78 Median $218.78 Typical High $870.96 | Professional | 52 · Reduced service | $218.78 | $218.78 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $346.74 | Professional | 53 · Discontinued | $87.10 | $87.10 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $257.04 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $173.78 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $173.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | RR · Rental | $52.48 | $52.48 | $56.23 |
Where Ohio sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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· 35th of 51
$525
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.