How much rates vary
Facilitymedian $316 · 10th to 90th $191 to $537Professionalmedian $158 · 10th to 90th $132 to $316
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 $158.49 Median $158.49 Typical High $575.44 | Facility | None | $158.49 | $158.49 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $537.03 | Professional | None | $158.49 | $158.49 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $645.65 | Facility | None | $281.84 | $346.74 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $380.19 | Professional | None | $144.54 | $177.83 | $380.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $107.15 Median $120.23 Typical High $158.49 | Professional | UE · Used equipment | $107.15 | $120.23 | $158.49 |
Aultcare Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | None | $257.04 | $257.04 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $218.78 Typical High $295.12 | Facility | None | $147.91 | $218.78 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $398.11 | Professional | None | $190.55 | $263.03 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $234.42 | Professional | None | $125.89 | $173.78 | $234.42 |
SummaCare Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $478.63 | Professional | None | $302.00 | $302.00 | $478.63 |
United Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $398.11 | Facility | None | $190.55 | $194.98 | $398.11 |
United Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $223.87 | Professional | None | $97.72 | $147.91 | $223.87 |
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 $79.43 Median $79.43 Typical High $269.15 | Professional | 52 · Reduced service | $79.43 | $79.43 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $107.15 | Professional | 53 · Discontinued | $31.62 | $31.62 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $81.28 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $53.70 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $19.05 | Professional | RR · Rental | $17.78 | $17.78 | $19.05 |
Where Ohio sits
The same service costs 3.5 times more in Hawaii than in Florida. 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
$158
HI $479FL $138
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.