How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,778 to $4,898Professionalmedian $1,380 · 10th to 90th $1,230 to $3,090
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 $1,348.96 Median $1,348.96 Typical High $6,025.60 | Facility | None | $1,348.96 | $1,348.96 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,168.69 | Professional | None | $1,348.96 | $1,348.96 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $6,025.60 | Facility | None | $2,630.27 | $3,235.94 | $6,025.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $3,548.13 | Professional | None | $1,348.96 | $1,479.11 | $3,548.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,023.29 Median $1,122.02 Typical High $1,479.11 | Professional | UE · Used equipment | $1,023.29 | $1,122.02 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,202.26 | $1,819.70 | $2,398.83 |
CareSource Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,584.89 | $2,187.76 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $3,235.94 | Professional | None | $1,737.80 | $2,398.83 | $3,235.94 |
SummaCare Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $4,365.16 | Professional | None | $2,818.38 | $2,818.38 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $3,311.31 | Facility | None | $1,412.54 | $1,548.82 | $3,311.31 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,995.26 | Professional | None | $912.01 | $1,348.96 | $1,995.26 |
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 $660.69 Median $660.69 Typical High $2,089.30 | Professional | 52 · Reduced service | $660.69 | $660.69 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $831.76 | Professional | 53 · Discontinued | $269.15 | $269.15 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $616.60 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $416.87 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | RR · Rental | $147.91 | $147.91 | $158.49 |
Where Ohio sits
The same service costs 2.7 times more in Hawaii than in Maryland. 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· 36th of 51
$1,479
HI $3,467MD $1,288
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.