How much rates vary
Facilitymedian $4,677 · 10th to 90th $2,754 to $7,762Professionalmedian $2,399 · 10th to 90th $1,995 to $4,467
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 $2,137.96 Median $2,137.96 Typical High $10,232.93 | Facility | None | $2,137.96 | $2,137.96 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $7,079.46 | Professional | None | $2,137.96 | $2,137.96 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $4,168.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $5,011.87 | Professional | None | $2,187.76 | $2,398.83 | $5,011.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,659.59 Median $1,778.28 Typical High $2,344.23 | Professional | UE · Used equipment | $1,659.59 | $1,778.28 | $2,344.23 |
CareSource Setting Facility Modifier None Typical Low $2,187.76 Median $3,311.31 Typical High $4,365.16 | Facility | None | $2,187.76 | $3,311.31 | $4,365.16 |
CareSource Setting Professional Modifier None Typical Low $2,884.03 Median $3,981.07 Typical High $5,888.44 | Professional | None | $2,884.03 | $3,981.07 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,995.26 | $1,995.26 | $2,754.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,995.26 | $1,995.26 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $4,365.16 | Professional | None | $2,398.83 | $3,235.94 | $4,365.16 |
SummaCare Setting Professional Modifier None Typical Low $4,466.84 Median $4,570.88 Typical High $7,079.46 | Professional | None | $4,466.84 | $4,570.88 | $7,079.46 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $5,370.32 | Facility | None | $2,187.76 | $2,398.83 | $5,370.32 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,445.44 | $2,187.76 | $3,162.28 |
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 $1,071.52 Median $1,071.52 Typical High $3,548.13 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $1,412.54 | Professional | 53 · Discontinued | $426.58 | $426.58 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $1,047.13 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $707.95 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $707.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | RR · Rental | $239.88 | $239.88 | $257.04 |
Where Ohio sits
The same service costs 2.6 times more in Hawaii than in West Virginia. 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· 37th of 51
$2,399
HI $5,129WV $1,995
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.