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 $169.82 Median $169.82 Typical High $562.34 | Facility | None | $169.82 | $169.82 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $389.05 | Professional | None | $169.82 | $169.82 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $407.38 Typical High $758.58 | Facility | None | $331.13 | $407.38 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $380.19 | Professional | None | $154.88 | $169.82 | $380.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $125.89 Typical High $173.78 | Professional | UE · Used equipment | $117.49 | $125.89 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $257.04 | Facility | None | $128.82 | $194.98 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $346.74 | Professional | None | $169.82 | $234.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | None | $117.49 | $117.49 | $162.18 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | None | $117.49 | $117.49 | $162.18 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $269.15 | Professional | None | $147.91 | $199.53 | $269.15 |
SummaCare Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $549.54 | Professional | None | $354.81 | $354.81 | $549.54 |
United Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $354.81 | Facility | None | $104.71 | $128.82 | $354.81 |
United Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $251.19 | Professional | None | $114.82 | $173.78 | $251.19 |
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 $85.11 Median $85.11 Typical High $194.98 | Professional | 52 · Reduced service | $85.11 | $85.11 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $77.62 | Professional | 53 · Discontinued | $33.88 | $33.88 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $58.88 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $38.90 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $38.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $15.49 Typical High $16.98 | Professional | RR · Rental | $15.49 | $15.49 | $16.98 |
Where Ohio sits
The same service costs 2.8 times more in Minnesota 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· 27th of 51
$170
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.