How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,318 to $3,981Professionalmedian $1,023 · 10th to 90th $912 to $2,188
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 $1,000.00 Median $1,000.00 Typical High $4,073.80 | Facility | None | $1,000.00 | $1,000.00 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,000.00 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $4,466.84 | Facility | None | $1,949.84 | $2,398.83 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,122.02 | $2,630.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $758.58 Median $831.76 Typical High $1,071.52 | Professional | UE · Used equipment | $758.58 | $831.76 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $2,041.74 | Facility | None | $1,023.29 | $1,548.82 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,862.09 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,621.81 | Professional | None | $870.96 | $1,174.90 | $1,621.81 |
SummaCare Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $3,311.31 | Professional | None | $2,089.30 | $2,089.30 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,454.71 | Facility | None | $1,000.00 | $1,000.00 | $2,454.71 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,479.11 | Professional | None | $676.08 | $1,023.29 | $1,479.11 |
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 $501.19 Median $501.19 Typical High $1,412.54 | Professional | 52 · Reduced service | $501.19 | $501.19 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $575.44 | Professional | 53 · Discontinued | $199.53 | $199.53 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $426.58 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $288.40 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $288.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | RR · Rental | $112.20 | $112.20 | $120.23 |
Where Ohio sits
The same service costs 3.0 times more in Kansas 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· 42nd of 51
$1,096
KS $2,818DE $955
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.