How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,413 to $3,548Professionalmedian $1,072 · 10th to 90th $912 to $2,042
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 $977.24 Median $977.24 Typical High $5,128.61 | Facility | None | $977.24 | $977.24 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $3,548.13 | Professional | None | $977.24 | $977.24 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $4,365.16 | Facility | None | $1,905.46 | $2,344.23 | $4,365.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $2,238.72 | Professional | None | $977.24 | $1,122.02 | $2,238.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $724.44 Median $812.83 Typical High $1,071.52 | Professional | UE · Used equipment | $724.44 | $812.83 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $1,819.70 | Facility | None | $912.01 | $1,380.38 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,659.59 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,584.89 | Professional | None | $851.14 | $1,174.90 | $1,584.89 |
SummaCare Setting Professional Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $3,235.94 | Professional | None | $2,041.74 | $2,089.30 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $2,511.89 | Facility | None | $1,230.27 | $1,318.26 | $2,511.89 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,445.44 | Professional | None | $660.69 | $1,000.00 | $1,445.44 |
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 $489.78 Median $489.78 Typical High $1,778.28 | Professional | 52 · Reduced service | $489.78 | $489.78 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $707.95 | Professional | 53 · Discontinued | $194.98 | $194.98 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $524.81 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $354.81 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $354.81 |
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 3.6 times more in Hawaii than in Washington, DC. 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· 39th of 51
$1,122
HI $3,548DC $977
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.