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 $120.23 Median $223.87 Typical High $407.38 | Facility | None | $120.23 | $223.87 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $660.69 | Professional | None | $120.23 | $120.23 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $331.13 | Professional | None | $104.71 | $123.03 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $141.25 | Professional | UE · Used equipment | $93.33 | $93.33 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $208.93 Typical High $275.42 | Facility | None | $138.04 | $208.93 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $371.54 | Professional | None | $177.83 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $213.80 | Facility | None | $194.98 | $194.98 | $213.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $316.23 | Professional | None | $169.82 | $234.42 | $316.23 |
SummaCare Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $371.54 | Professional | None | $251.19 | $275.42 | $371.54 |
United Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $181.97 | Professional | None | $83.18 | $123.03 | $181.97 |
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 $18.20 Median $18.20 Typical High $100.00 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $66.07 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $66.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $18.62 Typical High $22.91 | Professional | RR · Rental | $18.62 | $18.62 | $22.91 |
Where Ohio sits
The same service costs 2.6 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· 41st of 51
$158
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.