How much rates vary
Facilitymedian $1,230 · 10th to 90th $741 to $2,042Professionalmedian $603 · 10th to 90th $479 to $1,202
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 $602.56 Median $602.56 Typical High $2,187.76 | Facility | None | $602.56 | $602.56 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $2,041.74 | Professional | None | $602.56 | $602.56 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,454.71 | Facility | None | $1,096.48 | $1,348.96 | $2,454.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,445.44 | Professional | None | $549.54 | $645.65 | $1,445.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $416.87 Median $457.09 Typical High $602.56 | Professional | UE · Used equipment | $416.87 | $457.09 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $851.14 Typical High $1,122.02 | Facility | None | $562.34 | $851.14 | $1,122.02 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,513.56 | Professional | None | $741.31 | $1,023.29 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Molina Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $891.25 | Professional | None | $478.63 | $660.69 | $891.25 |
SummaCare Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,174.90 | $1,819.70 |
United Setting Facility Modifier None Typical Low $645.65 Median $691.83 Typical High $1,412.54 | Facility | None | $645.65 | $691.83 | $1,412.54 |
United Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $812.83 | Professional | None | $380.19 | $549.54 | $812.83 |
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 $302.00 Median $302.00 Typical High $1,023.29 | Professional | 52 · Reduced service | $302.00 | $302.00 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $407.38 | Professional | 53 · Discontinued | $123.03 | $123.03 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $302.00 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $204.17 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | RR · Rental | $66.07 | $66.07 | $81.28 |
Where Ohio sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 40th of 51
$603
HI $1,622VT $537
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.