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 $199.53 Median $199.53 Typical High $812.83 | Facility | None | $199.53 | $199.53 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $562.34 | Professional | None | $199.53 | $199.53 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $478.63 Typical High $891.25 | Facility | None | $389.05 | $478.63 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $524.81 | Professional | None | $204.17 | $204.17 | $524.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $151.36 Median $154.88 Typical High $218.78 | Professional | UE · Used equipment | $151.36 | $154.88 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $398.11 | Facility | None | $199.53 | $302.00 | $398.11 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $537.03 | Professional | None | $263.03 | $363.08 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $323.59 | Professional | None | $173.78 | $234.42 | $323.59 |
SummaCare Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $660.69 | Professional | None | $416.87 | $416.87 | $660.69 |
United Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $457.09 | Facility | None | $169.82 | $173.78 | $457.09 |
United Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $295.12 | Professional | None | $134.90 | $204.17 | $295.12 |
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 $100.00 Median $100.00 Typical High $281.84 | Professional | 52 · Reduced service | $100.00 | $100.00 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $112.20 | Professional | 53 · Discontinued | $39.81 | $39.81 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $83.18 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $56.23 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $56.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | RR · Rental | $20.42 | $20.42 | $22.39 |
Where Ohio sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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· 36th of 51
$204
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.