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 $204.17 Median $204.17 Typical High $2,238.72 | Facility | None | $204.17 | $204.17 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $1,548.82 | Professional | None | $204.17 | $204.17 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $562.34 | Professional | None | $177.83 | $208.93 | $562.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $158.49 Typical High $251.19 | Professional | UE · Used equipment | $158.49 | $158.49 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $436.52 | Facility | None | $218.78 | $331.13 | $436.52 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $588.84 | Professional | None | $288.40 | $398.11 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $660.69 | Professional | None | $354.81 | $489.78 | $660.69 |
SummaCare Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $676.08 | Professional | None | $426.58 | $436.52 | $676.08 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $323.59 | Professional | None | $141.25 | $208.93 | $323.59 |
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 $102.33 Median $102.33 Typical High $776.25 | Professional | 52 · Reduced service | $102.33 | $102.33 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $309.03 | Professional | 53 · Discontinued | $40.74 | $40.74 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $234.42 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $154.88 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $154.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | RR · Rental | $33.11 | $33.11 | $36.31 |
Where Ohio sits
The same service costs 3.4 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· 48th of 51
$251
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.