How much rates vary
Facilitymedian $302 · 10th to 90th $257 to $537Professionalmedian $234 · 10th to 90th $155 to $417
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 $141.25 Median $389.05 Typical High $741.31 | Facility | None | $141.25 | $389.05 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $741.31 | Professional | None | $141.25 | $141.25 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $446.68 | Professional | None | $309.03 | $416.87 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $316.23 Typical High $575.44 | Facility | None | $257.04 | $316.23 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $389.05 | Professional | None | $234.42 | $281.84 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | RR · Rental | $28.18 | $28.18 | $29.51 |
Aultcare Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $234.42 Typical High $309.03 | Facility | None | $154.88 | $234.42 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $416.87 | Professional | None | $204.17 | $281.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | RR · Rental | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Facility | None | $302.00 | $302.00 | $316.23 |
Medical Mutual of Ohio Setting Facility Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | RR · Rental | $30.20 | $30.20 | $30.20 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $331.13 | Professional | None | $151.36 | $218.78 | $331.13 |
Medical Mutual of Ohio Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $537.03 | Professional | None | $288.40 | $398.11 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $645.65 | Professional | None | $416.87 | $416.87 | $645.65 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $588.84 | Facility | None | $416.87 | $416.87 | $588.84 |
United Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $331.13 | Professional | None | $147.91 | $234.42 | $331.13 |
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 $70.79 Median $70.79 Typical High $371.54 | Professional | 52 · Reduced service | $70.79 | $70.79 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $147.91 | Professional | 53 · Discontinued | $28.18 | $28.18 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $112.20 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $74.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | UE · Used equipment | $213.80 | $213.80 | $213.80 |
Where Ohio sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 35th of 51
$245
HI $490UT $191
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.