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 $380.19 Median $380.19 Typical High $1,862.09 | Facility | None | $380.19 | $380.19 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $1,288.25 | Professional | None | $380.19 | $380.19 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $912.01 Typical High $1,698.24 | Facility | None | $741.31 | $912.01 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $1,000.00 | Professional | None | $380.19 | $416.87 | $1,000.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $309.03 Typical High $426.58 | Professional | UE · Used equipment | $288.40 | $309.03 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $524.81 Typical High $691.83 | Facility | None | $346.74 | $524.81 | $691.83 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $933.25 | Professional | None | $446.68 | $630.96 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $602.56 | Professional | None | $331.13 | $446.68 | $602.56 |
SummaCare Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,258.93 | Professional | None | $794.33 | $794.33 | $1,258.93 |
United Setting Facility Modifier None Typical Low $426.58 Median $467.74 Typical High $933.25 | Facility | None | $426.58 | $467.74 | $933.25 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $562.34 | Professional | None | $257.04 | $389.05 | $562.34 |
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 $190.55 Median $190.55 Typical High $645.65 | Professional | 52 · Reduced service | $190.55 | $190.55 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $257.04 | Professional | 53 · Discontinued | $75.86 | $75.86 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $194.98 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $128.82 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $128.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $44.67 | Professional | RR · Rental | $41.69 | $41.69 | $44.67 |
Where Ohio sits
The same service costs 3.0 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
$417
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.