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 $5,011.87 Median $9,120.11 Typical High $13,489.63 | Facility | None | $5,011.87 | $9,120.11 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $14,125.38 | Professional | None | $5,011.87 | $5,011.87 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $14,454.40 | Professional | None | $4,897.79 | $4,897.79 | $14,454.40 |
CareSource Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $10,232.93 | Facility | None | $5,011.87 | $7,585.78 | $10,232.93 |
CareSource Setting Professional Modifier None Typical Low $6,606.93 Median $9,120.11 Typical High $13,803.84 | Professional | None | $6,606.93 | $9,120.11 | $13,803.84 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $6,606.93 Median $8,912.51 Typical High $12,022.64 | Professional | None | $6,606.93 | $8,912.51 | $12,022.64 |
SummaCare Setting Professional Modifier None Typical Low $10,471.29 Median $10,964.78 Typical High $16,595.87 | Professional | None | $10,471.29 | $10,964.78 | $16,595.87 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $5,128.61 Typical High $7,413.10 | Professional | None | $3,467.37 | $5,128.61 | $7,413.10 |
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 $2,511.89 Median $2,511.89 Typical High $7,079.46 | Professional | 52 · Reduced service | $2,511.89 | $2,511.89 | $7,079.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,000.00 Typical High $2,818.38 | Professional | 53 · Discontinued | $1,000.00 | $1,000.00 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $758.58 Typical High $2,089.30 | Professional | 55 · Aftercare only | $758.58 | $758.58 | $2,089.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $501.19 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $501.19 | $501.19 | $1,412.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | RR · Rental | $724.44 | $724.44 | $851.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5,370.32 Median $5,370.32 Typical High $6,309.57 | Professional | UE · Used equipment | $5,370.32 | $5,370.32 | $6,309.57 |
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
$5,012
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.