How much rates vary
Facilitymedian $6,166 · 10th to 90th $3,631 to $10,233Professionalmedian $2,818 · 10th to 90th $2,399 to $6,026
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 $2,754.23 Median $2,754.23 Typical High $12,022.64 | Facility | None | $2,754.23 | $2,754.23 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $8,317.64 | Professional | None | $2,754.23 | $2,754.23 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $6,760.83 Typical High $12,302.69 | Facility | None | $5,495.41 | $6,760.83 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $7,244.36 | Professional | None | $2,818.38 | $2,818.38 | $7,244.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,089.30 Median $2,137.96 Typical High $2,884.03 | Professional | UE · Used equipment | $2,089.30 | $2,137.96 | $2,884.03 |
CareSource Setting Facility Modifier None Typical Low $2,290.87 Median $3,467.37 Typical High $4,570.88 | Facility | None | $2,290.87 | $3,467.37 | $4,570.88 |
CareSource Setting Professional Modifier None Typical Low $2,951.21 Median $4,168.69 Typical High $6,165.95 | Professional | None | $2,951.21 | $4,168.69 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,630.78 | Professional | None | $2,691.53 | $2,691.53 | $3,630.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,630.78 | Professional | None | $2,691.53 | $2,691.53 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $2,398.83 Median $3,311.31 Typical High $4,466.84 | Professional | None | $2,398.83 | $3,311.31 | $4,466.84 |
SummaCare Setting Professional Modifier None Typical Low $5,754.40 Median $5,888.44 Typical High $9,120.11 | Professional | None | $5,754.40 | $5,888.44 | $9,120.11 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $3,311.31 Typical High $6,165.95 | Facility | None | $3,090.30 | $3,311.31 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $4,073.80 | Professional | None | $1,905.46 | $2,818.38 | $4,073.80 |
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 $1,380.38 Median $1,380.38 Typical High $4,168.69 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $1,659.59 | Professional | 53 · Discontinued | $549.54 | $549.54 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $1,230.27 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $831.76 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $831.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $281.84 Median $281.84 Typical High $302.00 | Professional | RR · Rental | $281.84 | $281.84 | $302.00 |
Where Ohio sits
The same service costs 3.0 times more in Hawaii than in Pennsylvania. 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
$2,818
HI $7,413PA $2,455
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.