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 $323.59 Median $323.59 Typical High $1,348.96 | Facility | None | $323.59 | $323.59 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $933.25 | Professional | None | $323.59 | $323.59 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $891.25 | Professional | None | $281.84 | $331.13 | $891.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $251.19 Median $251.19 Typical High $371.54 | Professional | UE · Used equipment | $251.19 | $251.19 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $660.69 | Facility | None | $331.13 | $501.19 | $660.69 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $912.01 | Professional | None | $436.52 | $602.56 | $912.01 |
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 $426.58 Median $588.84 Typical High $794.33 | Professional | None | $426.58 | $588.84 | $794.33 |
SummaCare Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $1,071.52 | Professional | None | $676.08 | $691.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $478.63 | Professional | None | $223.87 | $331.13 | $478.63 |
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 $162.18 Median $162.18 Typical High $467.74 | Professional | 52 · Reduced service | $162.18 | $162.18 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $186.21 | Professional | 53 · Discontinued | $64.57 | $64.57 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $138.04 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $93.33 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $47.86 Typical High $54.95 | Professional | RR · Rental | $47.86 | $47.86 | $54.95 |
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· 43rd of 51
$331
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.