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 $1,412.54 Median $1,412.54 Typical High $2,454.71 | Facility | None | $1,412.54 | $1,412.54 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,412.54 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $3,467.37 Typical High $9,549.93 | Facility | None | $1,584.89 | $3,467.37 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $1,778.28 | Professional | None | $398.11 | $398.11 | $1,778.28 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $645.65 Typical High $870.96 | Facility | None | $436.52 | $645.65 | $870.96 |
CareSource Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,174.90 | Professional | None | $562.34 | $776.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | None | $407.38 | $407.38 | $478.63 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | None | $407.38 | $407.38 | $478.63 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,000.00 | Professional | None | $537.03 | $741.31 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,380.38 | Professional | None | $891.25 | $933.25 | $1,380.38 |
United Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $630.96 | Professional | None | $288.40 | $426.58 | $630.96 |
6 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 $707.95 Median $707.95 Typical High $851.14 | Professional | 52 · Reduced service | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $169.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $61.66 Median $147.91 Typical High $158.49 | Professional | RR · Rental | $61.66 | $147.91 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $457.09 Median $1,096.48 Typical High $1,174.90 | Professional | UE · Used equipment | $457.09 | $1,096.48 | $1,174.90 |
Where Ohio sits
The same service costs 3.2 times more in Michigan than in Ohio. 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· 51st of 51
$447
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.