How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,738 to $5,888Professionalmedian $1,698 · 10th to 90th $1,259 to $3,388
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 $1,621.81 Median $1,621.81 Typical High $6,918.31 | Facility | None | $1,621.81 | $1,621.81 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $4,897.79 | Professional | None | $1,621.81 | $1,621.81 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $3,890.45 Typical High $7,244.36 | Facility | None | $3,162.28 | $3,890.45 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $3,715.35 | Professional | None | $1,659.59 | $1,698.24 | $3,715.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,230.27 Median $1,258.93 Typical High $1,737.80 | Professional | UE · Used equipment | $1,230.27 | $1,258.93 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $2,884.03 | Facility | None | $1,445.44 | $2,187.76 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $3,890.45 | Professional | None | $1,862.09 | $2,570.40 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,778.28 | $2,454.71 | $3,311.31 |
SummaCare Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $5,248.07 | Professional | None | $3,388.44 | $3,388.44 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $3,801.89 | Facility | None | $1,445.44 | $1,621.81 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,659.59 | $2,398.83 |
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 $812.83 Median $812.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $977.24 | Professional | 53 · Discontinued | $323.59 | $323.59 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $724.44 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $489.78 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $489.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | RR · Rental | $169.82 | $169.82 | $181.97 |
Where Ohio sits
The same service costs 2.7 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· 34th of 51
$1,698
HI $3,388DE $1,259
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.