How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,549 to $5,370Professionalmedian $1,514 · 10th to 90th $1,122 to $3,236
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 $1,479.11 Median $1,479.11 Typical High $6,606.93 | Facility | None | $1,479.11 | $1,479.11 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $4,570.88 | Professional | None | $1,479.11 | $1,479.11 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $6,606.93 | Facility | None | $2,884.03 | $3,630.78 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $3,890.45 | Professional | None | $1,479.11 | $1,513.56 | $3,890.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | UE · Used equipment | $1,148.15 | $1,148.15 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $2,511.89 | Facility | None | $1,230.27 | $1,862.09 | $2,511.89 |
CareSource Setting Professional Modifier None Typical Low $1,621.81 Median $2,238.72 Typical High $3,388.44 | Professional | None | $1,621.81 | $2,238.72 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,778.28 | $2,398.83 |
SummaCare Setting Professional Modifier None Typical Low $3,090.30 Median $3,162.28 Typical High $4,897.79 | Professional | None | $3,090.30 | $3,162.28 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $3,388.44 | Facility | None | $1,479.11 | $1,698.24 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,513.56 | $2,187.76 |
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 $741.31 Median $741.31 Typical High $2,290.87 | Professional | 52 · Reduced service | $741.31 | $741.31 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $912.01 | Professional | 53 · Discontinued | $295.12 | $295.12 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $691.83 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $457.09 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $457.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | RR · Rental | $151.36 | $151.36 | $162.18 |
Where Ohio sits
The same service costs 3.0 times more in Iowa 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· 38th of 51
$1,514
IA $3,311DE $1,122
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.