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 $1,862.09 Median $1,862.09 Typical High $8,317.64 | Facility | None | $1,862.09 | $1,862.09 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $5,754.40 | Professional | None | $1,862.09 | $1,862.09 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $8,317.64 | Facility | None | $3,630.78 | $4,466.84 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $4,897.79 | Professional | None | $1,905.46 | $2,089.30 | $4,897.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,445.44 Median $1,548.82 Typical High $2,041.74 | Professional | UE · Used equipment | $1,445.44 | $1,548.82 | $2,041.74 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $3,801.89 | Facility | None | $1,905.46 | $2,884.03 | $3,801.89 |
CareSource Setting Professional Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Professional | None | $2,511.89 | $3,467.37 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,778.28 | $2,454.71 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,778.28 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $4,466.84 | Professional | None | $2,398.83 | $3,235.94 | $4,466.84 |
SummaCare Setting Professional Modifier None Typical Low $3,890.45 Median $3,981.07 Typical High $6,165.95 | Professional | None | $3,890.45 | $3,981.07 | $6,165.95 |
United Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $5,495.41 | Facility | None | $3,890.45 | $3,890.45 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,905.46 | $2,754.23 |
3 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 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $870.96 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $575.44 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $575.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | RR · Rental | $208.93 | $208.93 | $223.87 |
Where Ohio sits
The same service costs 2.3 times more in Montana 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· 37th of 51
$2,089
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.