How much rates vary
Facilitymedian $407 · 10th to 90th $209 to $676Professionalmedian $204 · 10th to 90th $155 to $398
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 $602.56 | Facility | None | $204.17 | $204.17 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $478.63 | Professional | None | $204.17 | $204.17 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $288.40 | Professional | None | $223.87 | $223.87 | $288.40 |
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 $489.78 | Professional | None | $186.21 | $223.87 | $489.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $154.88 Typical High $199.53 | Professional | UE · Used equipment | $138.04 | $154.88 | $199.53 |
Aultcare Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | None | $331.13 | $331.13 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $288.40 Typical High $380.19 | Facility | None | $190.55 | $288.40 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $602.56 | Professional | None | $338.84 | $512.86 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $354.81 | Professional | None | $154.88 | $154.88 | $354.81 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $199.53 | Professional | None | $107.15 | $147.91 | $199.53 |
SummaCare Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $616.60 | Professional | None | $263.03 | $389.05 | $616.60 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $549.54 | Facility | None | $389.05 | $389.05 | $549.54 |
United Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $275.42 | Professional | None | $125.89 | $181.97 | $275.42 |
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 $302.00 | Professional | 52 · Reduced service | $102.33 | $102.33 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $120.23 | Professional | 53 · Discontinued | $40.74 | $40.74 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $89.13 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $60.26 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $23.99 | Professional | RR · Rental | $21.88 | $21.88 | $23.99 |
Where Ohio sits
The same service costs 2.4 times more in Hawaii 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· 35th of 51
$204
HI $380DE $158
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.