How much rates vary
Facilitymedian $3,802 · 10th to 90th $2,291 to $6,310Professionalmedian $1,778 · 10th to 90th $1,660 to $3,631
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 $1,737.80 Median $1,737.80 Typical High $7,244.36 | Facility | None | $1,737.80 | $1,737.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $5,011.87 | Professional | None | $1,737.80 | $1,737.80 | $5,011.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $4,168.69 Typical High $7,762.47 | Facility | None | $3,388.44 | $4,168.69 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $3,981.07 | Professional | None | $1,737.80 | $1,778.28 | $3,981.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,318.26 Median $1,318.26 Typical High $1,862.09 | Professional | UE · Used equipment | $1,318.26 | $1,318.26 | $1,862.09 |
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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,659.59 | $2,290.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,659.59 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $2,511.89 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,511.89 | $3,388.44 |
SummaCare Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $5,754.40 | Professional | None | $3,630.78 | $3,630.78 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $3,890.45 | Facility | None | $1,778.28 | $1,905.46 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,778.28 | $2,570.40 |
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 $870.96 Median $870.96 Typical High $2,511.89 | Professional | 52 · Reduced service | $870.96 | $870.96 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $1,000.00 | Professional | 53 · Discontinued | $346.74 | $346.74 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $741.31 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $501.19 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | RR · Rental | $173.78 | $173.78 | $190.55 |
Where Ohio sits
The same service costs 2.8 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
$1,778
HI $4,365PA $1,549
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.