How much rates vary
Facilitymedian $347 · 10th to 90th $204 to $575Professionalmedian $162 · 10th to 90th $148 to $347
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 $158.49 Median $158.49 Typical High $812.83 | Facility | None | $158.49 | $158.49 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $562.34 | Professional | None | $158.49 | $158.49 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $389.05 Typical High $707.95 | Facility | None | $309.03 | $389.05 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $416.87 | Professional | None | $158.49 | $194.98 | $416.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $120.23 Median $134.90 Typical High $173.78 | Professional | UE · Used equipment | $120.23 | $134.90 | $173.78 |
Aultcare Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $245.47 Typical High $323.59 | Facility | None | $162.18 | $245.47 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $436.52 | Professional | None | $213.80 | $295.12 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $257.04 | Professional | None | $138.04 | $190.55 | $257.04 |
SummaCare Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $524.81 | Professional | None | $331.13 | $338.84 | $524.81 |
United Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $446.68 | Facility | None | $181.97 | $218.78 | $446.68 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $251.19 | Professional | None | $107.15 | $162.18 | $251.19 |
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 $79.43 Median $79.43 Typical High $281.84 | Professional | 52 · Reduced service | $79.43 | $79.43 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $112.20 | Professional | 53 · Discontinued | $31.62 | $31.62 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $85.11 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $56.23 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $56.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $21.38 | Professional | RR · Rental | $19.50 | $19.50 | $21.38 |
Where Ohio sits
The same service costs 3.3 times more in Hawaii 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· 48th of 51
$174
HI $501DE $151
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.