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 $338.84 Median $338.84 Typical High $1,737.80 | Facility | None | $338.84 | $338.84 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $1,202.26 | Professional | None | $338.84 | $338.84 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $812.83 Typical High $1,513.56 | Facility | None | $660.69 | $812.83 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $776.25 | Professional | None | $346.74 | $416.87 | $776.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $263.03 Median $288.40 Typical High $380.19 | Professional | UE · Used equipment | $263.03 | $288.40 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $524.81 Typical High $691.83 | Facility | None | $346.74 | $524.81 | $691.83 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $933.25 | Professional | None | $446.68 | $616.60 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $549.54 | Professional | None | $295.12 | $407.38 | $549.54 |
SummaCare Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $1,122.02 | Professional | None | $707.95 | $724.44 | $1,122.02 |
United Setting Facility Modifier None Typical Low $257.04 Median $346.74 Typical High $933.25 | Facility | None | $257.04 | $346.74 | $933.25 |
United Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $537.03 | Professional | None | $229.09 | $346.74 | $537.03 |
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 $169.82 Median $169.82 Typical High $602.56 | Professional | 52 · Reduced service | $169.82 | $169.82 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $239.88 | Professional | 53 · Discontinued | $67.61 | $67.61 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $181.97 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $120.23 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $120.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $45.71 | Professional | RR · Rental | $41.69 | $41.69 | $45.71 |
Where Ohio sits
The same service costs 2.8 times more in Montana than in Florida. 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· 38th of 51
$417
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.