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 $676.08 Median $676.08 Typical High $2,951.21 | Facility | None | $676.08 | $676.08 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $2,041.74 | Professional | None | $676.08 | $676.08 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $3,019.95 | Facility | None | $1,348.96 | $1,659.59 | $3,019.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,548.82 | Professional | None | $691.83 | $691.83 | $1,548.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $524.81 Median $524.81 Typical High $741.31 | Professional | UE · Used equipment | $524.81 | $524.81 | $741.31 |
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 $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $933.25 | Professional | None | $676.08 | $676.08 | $933.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $933.25 | Professional | None | $676.08 | $676.08 | $933.25 |
Molina Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,096.48 | Professional | None | $588.84 | $812.83 | $1,096.48 |
SummaCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,445.44 | $2,238.72 |
United Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $1,584.89 | Facility | None | $478.63 | $575.44 | $1,584.89 |
United Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,000.00 | Professional | None | $467.74 | $691.83 | $1,000.00 |
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 $338.84 Median $338.84 Typical High $1,023.29 | Professional | 52 · Reduced service | $338.84 | $338.84 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $407.38 | Professional | 53 · Discontinued | $134.90 | $134.90 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $309.03 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $204.17 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | RR · Rental | $69.18 | $69.18 | $75.86 |
Where Ohio sits
The same service costs 2.1 times more in Wisconsin than in Washington, DC. 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· 34th of 51
$692
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.