How much rates vary
Facilitymedian $1,259 · 10th to 90th $741 to $2,138Professionalmedian $631 · 10th to 90th $537 to $1,288
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 $630.96 Median $1,737.80 Typical High $2,137.96 | Facility | None | $630.96 | $1,737.80 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $2,089.30 | Professional | None | $630.96 | $630.96 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,570.40 | Facility | None | $1,122.02 | $1,380.38 | $2,570.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,513.56 | Professional | None | $575.44 | $707.95 | $1,513.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $426.58 Median $478.63 Typical High $630.96 | Professional | UE · Used equipment | $426.58 | $478.63 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $891.25 Typical High $1,174.90 | Facility | None | $588.84 | $891.25 | $1,174.90 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,584.89 | Professional | None | $758.58 | $1,071.52 | $1,584.89 |
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 $501.19 Median $691.83 Typical High $933.25 | Professional | None | $501.19 | $691.83 | $933.25 |
SummaCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,230.27 | $1,905.46 |
United Setting Facility Modifier None Typical Low $776.25 Median $912.01 Typical High $1,584.89 | Facility | None | $776.25 | $912.01 | $1,584.89 |
United Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $891.25 | Professional | None | $389.05 | $588.84 | $891.25 |
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 $316.23 Median $316.23 Typical High $1,047.13 | Professional | 52 · Reduced service | $316.23 | $316.23 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $426.58 | Professional | 53 · Discontinued | $125.89 | $125.89 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $316.23 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $208.93 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $208.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | RR · Rental | $70.79 | $70.79 | $77.62 |
Where Ohio sits
The same service costs 4.6 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· 42nd of 51
$631
HI $2,455DE $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.