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 $467.74 Median $467.74 Typical High $2,187.76 | Facility | None | $467.74 | $467.74 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,513.56 | Professional | None | $467.74 | $467.74 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,089.30 | Facility | None | $912.01 | $1,122.02 | $2,089.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $1,071.52 | Professional | None | $478.63 | $537.03 | $1,071.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $354.81 Median $398.11 Typical High $512.86 | Professional | UE · Used equipment | $354.81 | $398.11 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $660.69 Typical High $870.96 | Facility | None | $436.52 | $660.69 | $870.96 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,174.90 | Professional | None | $575.44 | $794.33 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $741.31 | Professional | None | $398.11 | $549.54 | $741.31 |
SummaCare Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,513.56 | Professional | None | $977.24 | $977.24 | $1,513.56 |
United Setting Facility Modifier None Typical Low $588.84 Median $707.95 Typical High $1,202.26 | Facility | None | $588.84 | $707.95 | $1,202.26 |
United Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $691.83 | Professional | None | $316.23 | $467.74 | $691.83 |
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 $229.09 Median $229.09 Typical High $758.58 | Professional | 52 · Reduced service | $229.09 | $229.09 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $302.00 | Professional | 53 · Discontinued | $93.33 | $93.33 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $229.09 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $151.36 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $151.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | RR · Rental | $53.70 | $53.70 | $57.54 |
Where Ohio sits
The same service costs 3.7 times more in Hawaii than in Tennessee. 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· 39th of 51
$537
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.