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 $524.81 Median $524.81 Typical High $3,467.37 | Facility | None | $524.81 | $524.81 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $2,398.83 | Professional | None | $524.81 | $524.81 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,344.23 | Facility | None | $1,023.29 | $1,258.93 | $2,344.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $1,380.38 | Professional | None | $501.19 | $537.03 | $1,380.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $380.19 Median $407.38 Typical High $549.54 | Professional | UE · Used equipment | $380.19 | $407.38 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $891.25 | Facility | None | $446.68 | $676.08 | $891.25 |
CareSource Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,202.26 | Professional | None | $588.84 | $812.83 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | None | $512.86 | $512.86 | $691.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | None | $512.86 | $512.86 | $691.83 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $851.14 | Professional | None | $457.09 | $630.96 | $851.14 |
SummaCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,122.02 | $1,737.80 |
United Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $1,122.02 | Facility | None | $398.11 | $501.19 | $1,122.02 |
United Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $776.25 | Professional | None | $354.81 | $537.03 | $776.25 |
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 $263.03 Median $263.03 Typical High $1,202.26 | Professional | 52 · Reduced service | $263.03 | $263.03 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $478.63 | Professional | 53 · Discontinued | $104.71 | $104.71 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $363.08 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $239.88 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $239.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | RR · Rental | $50.12 | $50.12 | $53.70 |
Where Ohio sits
The same service costs 2.4 times more in Hawaii than in Washington, DC. 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· 30th of 51
$537
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.