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 $478.63 Median $478.63 Typical High $1,659.59 | Facility | None | $478.63 | $478.63 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,148.15 | Professional | None | $478.63 | $478.63 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $1,148.15 Typical High $2,137.96 | Facility | None | $933.25 | $1,148.15 | $2,137.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $1,258.93 | Professional | None | $457.09 | $489.78 | $1,258.93 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $371.54 Typical High $501.19 | Professional | UE · Used equipment | $346.74 | $371.54 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $912.01 | Facility | None | $457.09 | $691.83 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,230.27 | Professional | None | $602.56 | $831.76 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $776.25 | Professional | None | $416.87 | $575.44 | $776.25 |
SummaCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,023.29 | $1,584.89 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $1,023.29 | Facility | None | $489.78 | $489.78 | $1,023.29 |
United Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $707.95 | Professional | None | $323.59 | $489.78 | $707.95 |
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 $239.88 Median $239.88 Typical High $575.44 | Professional | 52 · Reduced service | $239.88 | $239.88 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $229.09 | Professional | 53 · Discontinued | $95.50 | $95.50 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $169.82 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $114.82 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $114.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $50.12 | Professional | RR · Rental | $45.71 | $45.71 | $50.12 |
Where Ohio sits
The same service costs 2.7 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· 31st of 51
$490
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.