How much rates vary
Facilitymedian $2,042 · 10th to 90th $1,175 to $3,388Professionalmedian $1,000 · 10th to 90th $851 to $2,042
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 $1,023.29 Median $1,023.29 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,023.29 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $3,162.28 | Professional | None | $1,023.29 | $1,023.29 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $4,073.80 | Facility | None | $1,819.70 | $2,238.72 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $2,454.71 | Professional | None | $912.01 | $1,096.48 | $2,454.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $691.83 Median $776.25 Typical High $1,047.13 | Professional | UE · Used equipment | $691.83 | $776.25 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,148.15 | $1,698.24 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,479.11 | $2,041.74 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,479.11 | Professional | None | $794.33 | $1,096.48 | $1,479.11 |
SummaCare Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,905.46 | $1,949.84 | $3,019.95 |
United Setting Facility Modifier None Typical Low $870.96 Median $933.25 Typical High $2,570.40 | Facility | None | $870.96 | $933.25 | $2,570.40 |
United Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,412.54 | Professional | None | $630.96 | $933.25 | $1,412.54 |
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 $501.19 Median $501.19 Typical High $1,584.89 | Professional | 52 · Reduced service | $501.19 | $501.19 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $630.96 | Professional | 53 · Discontinued | $204.17 | $204.17 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $478.63 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $316.23 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $316.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | RR · Rental | $114.82 | $114.82 | $151.36 |
Where Ohio sits
The same service costs 3.0 times more in Montana than in Delaware. 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· 47th of 51
$1,023
MT $2,570DE $851
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.