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 $1,288.25 Median $1,288.25 Typical High $6,918.31 | Facility | None | $1,288.25 | $1,288.25 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $4,786.30 | Professional | None | $1,288.25 | $1,288.25 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $3,548.13 | Professional | None | $1,122.02 | $1,318.26 | $3,548.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,000.00 Median $1,000.00 Typical High $1,513.56 | Professional | UE · Used equipment | $1,000.00 | $1,000.00 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $2,691.53 | Facility | None | $1,348.96 | $2,041.74 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,454.71 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $1,621.81 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,621.81 | $2,238.72 | $3,019.95 |
SummaCare Setting Professional Modifier None Typical Low $2,691.53 Median $2,754.23 Typical High $4,265.80 | Professional | None | $2,691.53 | $2,754.23 | $4,265.80 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,905.46 | Professional | None | $891.25 | $1,318.26 | $1,905.46 |
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 $645.65 Median $645.65 Typical High $2,398.83 | Professional | 52 · Reduced service | $645.65 | $645.65 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $954.99 | Professional | 53 · Discontinued | $257.04 | $257.04 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $724.44 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $478.63 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $478.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | RR · Rental | $190.55 | $190.55 | $223.87 |
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
$1,318
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.