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 $223.87 Median $223.87 Typical High $1,071.52 | Facility | None | $223.87 | $223.87 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $758.58 | Professional | None | $223.87 | $223.87 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $1,000.00 | Facility | None | $446.68 | $549.54 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $602.56 | Professional | None | $234.42 | $245.47 | $602.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $173.78 Median $181.97 Typical High $245.47 | Professional | UE · Used equipment | $173.78 | $181.97 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $407.38 | Facility | None | $204.17 | $309.03 | $407.38 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $549.54 | Professional | None | $263.03 | $371.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $363.08 | Professional | None | $194.98 | $269.15 | $363.08 |
SummaCare Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $741.31 | Professional | None | $467.74 | $478.63 | $741.31 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $549.54 | Facility | None | $251.19 | $251.19 | $549.54 |
United Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $338.84 | Professional | None | $154.88 | $229.09 | $338.84 |
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 $112.20 Median $112.20 Typical High $371.54 | Professional | 52 · Reduced service | $112.20 | $112.20 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $151.36 | Professional | 53 · Discontinued | $45.71 | $45.71 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $112.20 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $75.86 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $26.30 | Professional | RR · Rental | $24.55 | $24.55 | $26.30 |
Where Ohio sits
The same service costs 2.5 times more in Hawaii than in Pennsylvania. 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
$245
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.