How much rates vary
Facilitymedian $407 · 10th to 90th $234 to $724Professionalmedian $204 · 10th to 90th $174 to $389
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 $204.17 Median $204.17 Typical High $776.25 | Facility | None | $204.17 | $204.17 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $724.44 | Professional | None | $204.17 | $204.17 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $446.68 Typical High $831.76 | Facility | None | $363.08 | $446.68 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $426.58 | Professional | None | $186.21 | $223.87 | $426.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $154.88 Typical High $204.17 | Professional | UE · Used equipment | $138.04 | $154.88 | $204.17 |
Aultcare Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $281.84 Typical High $380.19 | Facility | None | $190.55 | $281.84 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $512.86 | Professional | None | $245.47 | $338.84 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $295.12 | Professional | None | $162.18 | $218.78 | $295.12 |
SummaCare Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $616.60 | Professional | None | $389.05 | $389.05 | $616.60 |
United Setting Facility Modifier None Typical Low $251.19 Median $380.19 Typical High $512.86 | Facility | None | $251.19 | $380.19 | $512.86 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $281.84 | Professional | None | $125.89 | $190.55 | $281.84 |
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 $102.33 Median $102.33 Typical High $363.08 | Professional | 52 · Reduced service | $102.33 | $102.33 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $144.54 | Professional | 53 · Discontinued | $40.74 | $40.74 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $109.65 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $72.44 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $72.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.39 Median $22.39 Typical High $23.99 | Professional | RR · Rental | $22.39 | $22.39 | $23.99 |
Where Ohio sits
The same service costs 5.5 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· 40th of 51
$219
HI $955FL $174
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.