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 $275.42 Median $275.42 Typical High $1,258.93 | Facility | None | $275.42 | $275.42 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $870.96 | Professional | None | $275.42 | $275.42 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $660.69 Typical High $1,230.27 | Facility | None | $537.03 | $660.69 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $724.44 | Professional | None | $281.84 | $302.00 | $724.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $229.09 Typical High $302.00 | Professional | UE · Used equipment | $208.93 | $229.09 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $281.84 Median $426.58 Typical High $562.34 | Facility | None | $281.84 | $426.58 | $562.34 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $758.58 | Professional | None | $363.08 | $501.19 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $512.86 | Professional | None | $275.42 | $380.19 | $512.86 |
SummaCare Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $912.01 | Professional | None | $575.44 | $575.44 | $912.01 |
United Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $812.83 | Facility | None | $575.44 | $575.44 | $812.83 |
United Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $407.38 | Professional | None | $186.21 | $281.84 | $407.38 |
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 $138.04 Median $138.04 Typical High $436.52 | Professional | 52 · Reduced service | $138.04 | $138.04 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $173.78 | Professional | 53 · Discontinued | $54.95 | $54.95 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $131.83 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $87.10 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $87.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.90 Median $30.90 Typical High $33.11 | Professional | RR · Rental | $30.90 | $30.90 | $33.11 |
Where Ohio sits
The same service costs 2.2 times more in Montana 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· 38th of 51
$302
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.