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 $257.04 Median $257.04 Typical High $1,548.82 | Facility | None | $257.04 | $257.04 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $1,071.52 | Professional | None | $257.04 | $257.04 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $707.95 | Professional | None | $223.87 | $263.03 | $707.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $295.12 | Professional | UE · Used equipment | $199.53 | $199.53 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $524.81 | Facility | None | $263.03 | $398.11 | $524.81 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $707.95 | Professional | None | $338.84 | $478.63 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | None | $354.81 | $354.81 | $416.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | None | $354.81 | $354.81 | $416.87 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $630.96 | Professional | None | $338.84 | $467.74 | $630.96 |
SummaCare Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $851.14 | Professional | None | $537.03 | $549.54 | $851.14 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $380.19 | Professional | None | $173.78 | $263.03 | $380.19 |
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 $128.82 Median $128.82 Typical High $537.03 | Professional | 52 · Reduced service | $128.82 | $128.82 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $218.78 | Professional | 53 · Discontinued | $51.29 | $51.29 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $162.18 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $107.15 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | RR · Rental | $37.15 | $37.15 | $43.65 |
Where Ohio sits
The same service costs 2.5 times more in Montana than in New York. 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
$324
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.