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 $2,691.53 | Facility | None | $275.42 | $275.42 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $1,862.09 | Professional | None | $275.42 | $275.42 | $1,862.09 |
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 $275.42 Median $295.12 Typical High $724.44 | Professional | None | $275.42 | $295.12 | $724.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $218.78 Typical High $309.03 | Professional | UE · Used equipment | $213.80 | $218.78 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $363.08 Typical High $478.63 | Facility | None | $239.88 | $363.08 | $478.63 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $645.65 | Professional | None | $316.23 | $436.52 | $645.65 |
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 $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $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 $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $660.69 | Professional | None | $354.81 | $489.78 | $660.69 |
SummaCare Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $912.01 | Professional | None | $575.44 | $588.84 | $912.01 |
United Setting Facility Modifier None Typical Low $239.88 Median $323.59 Typical High $660.69 | Facility | None | $239.88 | $323.59 | $660.69 |
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 $933.25 | Professional | 52 · Reduced service | $138.04 | $138.04 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $371.54 | Professional | 53 · Discontinued | $54.95 | $54.95 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $281.84 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $186.21 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $186.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $29.51 Median $29.51 Typical High $31.62 | Professional | RR · Rental | $29.51 | $29.51 | $31.62 |
Where Ohio sits
The same service costs 2.6 times more in Hawaii than in Vermont. 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
$295
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.