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 $229.09 Median $229.09 Typical High $1,174.90 | Facility | None | $229.09 | $229.09 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $812.83 | Professional | None | $229.09 | $229.09 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $562.34 Typical High $1,023.29 | Facility | None | $446.68 | $562.34 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $524.81 | Professional | None | $234.42 | $281.84 | $524.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $199.53 Typical High $251.19 | Professional | UE · Used equipment | $177.83 | $199.53 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $467.74 | Facility | None | $234.42 | $354.81 | $467.74 |
CareSource Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $630.96 | Professional | None | $309.03 | $426.58 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | None | $213.80 | $213.80 | $295.12 |
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 $478.63 Median $489.78 Typical High $758.58 | Professional | None | $478.63 | $489.78 | $758.58 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $691.83 | Facility | None | $489.78 | $489.78 | $691.83 |
United Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $338.84 | Professional | None | $154.88 | $234.42 | $338.84 |
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 $34.67 Median $34.67 Typical High $123.03 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $81.28 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $28.18 Typical High $30.20 | Professional | RR · Rental | $28.18 | $28.18 | $30.20 |
Where Ohio sits
The same service costs 3.0 times more in Hawaii than in Kansas. 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
$282
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.