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 $239.88 Median $239.88 Typical High $1,174.90 | Facility | None | $239.88 | $239.88 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $812.83 | Professional | None | $239.88 | $239.88 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $575.44 Typical High $1,071.52 | Facility | None | $467.74 | $575.44 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $630.96 | Professional | None | $245.47 | $269.15 | $630.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $199.53 Typical High $263.03 | Professional | UE · Used equipment | $181.97 | $199.53 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $446.68 | Facility | None | $223.87 | $338.84 | $446.68 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $602.56 | Professional | None | $295.12 | $407.38 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $380.19 | Professional | None | $208.93 | $281.84 | $380.19 |
SummaCare Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $794.33 | Professional | None | $501.19 | $501.19 | $794.33 |
United Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $602.56 | Facility | None | $213.80 | $257.04 | $602.56 |
United Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $354.81 | Professional | None | $162.18 | $245.47 | $354.81 |
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 $120.23 Median $120.23 Typical High $407.38 | Professional | 52 · Reduced service | $120.23 | $120.23 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $162.18 | Professional | 53 · Discontinued | $47.86 | $47.86 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $120.23 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $81.28 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $28.84 | Professional | RR · Rental | $26.92 | $26.92 | $28.84 |
Where Ohio sits
The same service costs 2.5 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· 41st of 51
$263
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.