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 $346.74 Median $346.74 Typical High $1,737.80 | Facility | None | $346.74 | $346.74 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,230.27 | Professional | None | $346.74 | $346.74 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $831.76 Typical High $1,548.82 | Facility | None | $676.08 | $831.76 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $776.25 | Professional | None | $346.74 | $457.09 | $776.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $288.40 Typical High $380.19 | Professional | UE · Used equipment | $257.04 | $288.40 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $575.44 Typical High $758.58 | Facility | None | $380.19 | $575.44 | $758.58 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,023.29 | Professional | None | $489.78 | $691.83 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $549.54 | Professional | None | $302.00 | $407.38 | $549.54 |
SummaCare Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,148.15 | Professional | None | $724.44 | $724.44 | $1,148.15 |
United Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $954.99 | Facility | None | $467.74 | $467.74 | $954.99 |
United Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $537.03 | Professional | None | $234.42 | $354.81 | $537.03 |
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 $173.78 Median $173.78 Typical High $602.56 | Professional | 52 · Reduced service | $173.78 | $173.78 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $245.47 | Professional | 53 · Discontinued | $69.18 | $69.18 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $181.97 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $123.03 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $123.03 |
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 2.8 times more in Iowa 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· 42nd of 51
$427
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.