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 $309.03 Median $309.03 Typical High $2,290.87 | Facility | None | $309.03 | $309.03 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $1,584.89 | Professional | None | $309.03 | $309.03 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $758.58 Typical High $1,380.38 | Facility | None | $616.60 | $758.58 | $1,380.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $831.76 | Professional | None | $316.23 | $389.05 | $831.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $263.03 Typical High $346.74 | Professional | UE · Used equipment | $239.88 | $263.03 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $549.54 Typical High $724.44 | Facility | None | $363.08 | $549.54 | $724.44 |
CareSource Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $977.24 | Professional | None | $478.63 | $660.69 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $416.87 | Professional | None | $302.00 | $302.00 | $416.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $416.87 | Professional | None | $302.00 | $302.00 | $416.87 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $501.19 | Professional | None | $269.15 | $371.54 | $501.19 |
SummaCare Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,023.29 | Professional | None | $645.65 | $660.69 | $1,023.29 |
United Setting Facility Modifier None Typical Low $426.58 Median $467.74 Typical High $870.96 | Facility | None | $426.58 | $467.74 | $870.96 |
United Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $489.78 | Professional | None | $213.80 | $316.23 | $489.78 |
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 $154.88 Median $154.88 Typical High $794.33 | Professional | 52 · Reduced service | $154.88 | $154.88 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $316.23 | Professional | 53 · Discontinued | $61.66 | $61.66 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $234.42 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $158.49 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $41.69 | Professional | RR · Rental | $38.90 | $38.90 | $41.69 |
Where Ohio sits
The same service costs 3.9 times more in Hawaii 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· 44th of 51
$347
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.