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 $302.00 Median $302.00 Typical High $1,258.93 | Facility | None | $302.00 | $302.00 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $891.25 | Professional | None | $302.00 | $302.00 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $741.31 Typical High $1,348.96 | Facility | None | $588.84 | $741.31 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $794.33 | Professional | None | $302.00 | $323.59 | $794.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $234.42 Median $239.88 Typical High $323.59 | Professional | UE · Used equipment | $234.42 | $239.88 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $524.81 | Facility | None | $263.03 | $398.11 | $524.81 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $707.95 | Professional | None | $346.74 | $478.63 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $724.44 | Professional | None | $389.05 | $537.03 | $724.44 |
SummaCare Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $1,000.00 | Professional | None | $630.96 | $645.65 | $1,000.00 |
United Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $724.44 | Facility | None | $257.04 | $331.13 | $724.44 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $446.68 | Professional | None | $208.93 | $309.03 | $446.68 |
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 $151.36 Median $151.36 Typical High $436.52 | Professional | 52 · Reduced service | $151.36 | $151.36 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $177.83 | Professional | 53 · Discontinued | $60.26 | $60.26 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $131.83 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $89.13 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $89.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $34.67 | Professional | RR · Rental | $32.36 | $32.36 | $34.67 |
Where Ohio sits
The same service costs 2.5 times more in Hawaii 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· 38th of 51
$324
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.