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 $74.13 Median $74.13 Typical High $302.00 | Facility | None | $74.13 | $74.13 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $208.93 | Professional | None | $74.13 | $74.13 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $331.13 | Facility | None | $144.54 | $177.83 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $194.98 | Professional | None | $74.13 | $91.20 | $194.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $63.10 Typical High $83.18 | Professional | UE · Used equipment | $54.95 | $63.10 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $114.82 Typical High $151.36 | Facility | None | $75.86 | $114.82 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $204.17 | Professional | None | $100.00 | $138.04 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $173.78 | Professional | None | $95.50 | $128.82 | $173.78 |
SummaCare Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $245.47 | Professional | None | $154.88 | $158.49 | $245.47 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $218.78 | Facility | None | $154.88 | $154.88 | $218.78 |
United Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $120.23 | Professional | None | $50.12 | $75.86 | $120.23 |
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 $10.96 Median $10.96 Typical High $31.62 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $20.89 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.23 Median $10.23 Typical High $10.72 | Professional | RR · Rental | $10.23 | $10.23 | $10.72 |
Where Ohio sits
The same service costs 4.2 times more in Kansas than in Delaware. 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· 43rd of 51
$81.28
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.