How much rates vary
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 $1,862.09 Median $1,862.09 Typical High $8,912.51 | Facility | None | $1,862.09 | $1,862.09 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $6,165.95 | Professional | None | $1,862.09 | $1,862.09 | $6,165.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $8,128.31 | Facility | None | $3,630.78 | $4,466.84 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $4,897.79 | Professional | None | $1,905.46 | $2,041.74 | $4,897.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $1,548.82 Typical High $2,041.74 | Professional | UE · Used equipment | $1,412.54 | $1,548.82 | $2,041.74 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $3,801.89 | Facility | None | $1,905.46 | $2,818.38 | $3,801.89 |
CareSource Setting Professional Modifier None Typical Low $2,454.71 Median $3,388.44 Typical High $5,128.61 | Professional | None | $2,454.71 | $3,388.44 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,949.84 | $1,949.84 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,949.84 | $1,949.84 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $2,951.21 | Professional | None | $1,584.89 | $2,187.76 | $2,951.21 |
SummaCare Setting Professional Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,025.60 | Professional | None | $3,801.89 | $3,890.45 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $4,570.88 | Facility | None | $1,819.70 | $1,819.70 | $4,570.88 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,862.09 | $2,754.23 |
3 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 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $933.25 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $616.60 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $616.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | RR · Rental | $204.17 | $204.17 | $223.87 |
Where Ohio sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 43rd of 51
$1,995
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.