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 $5,011.87 Median $5,011.87 Typical High $20,417.38 | Facility | None | $5,011.87 | $5,011.87 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $14,125.38 | Professional | None | $5,011.87 | $5,011.87 | $14,125.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,302.69 Typical High $22,387.21 | Facility | None | $9,772.37 | $12,302.69 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,128.61 Median $5,623.41 Typical High $13,182.57 | Professional | None | $5,128.61 | $5,623.41 | $13,182.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,890.45 Median $4,265.80 Typical High $5,495.41 | Professional | UE · Used equipment | $3,890.45 | $4,265.80 | $5,495.41 |
CareSource Setting Facility Modifier None Typical Low $5,128.61 Median $7,762.47 Typical High $10,232.93 | Facility | None | $5,128.61 | $7,762.47 | $10,232.93 |
CareSource Setting Professional Modifier None Typical Low $6,760.83 Median $9,332.54 Typical High $13,803.84 | Professional | None | $6,760.83 | $9,332.54 | $13,803.84 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,606.93 | Professional | None | $4,897.79 | $4,897.79 | $6,606.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,606.93 | Professional | None | $4,897.79 | $4,897.79 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $2,754.23 Median $3,801.89 Typical High $5,128.61 | Professional | None | $2,754.23 | $3,801.89 | $5,128.61 |
SummaCare Setting Professional Modifier None Typical Low $10,471.29 Median $10,715.19 Typical High $16,595.87 | Professional | None | $10,471.29 | $10,715.19 | $16,595.87 |
United Setting Facility Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $15,135.61 | Facility | None | $10,715.19 | $10,715.19 | $15,135.61 |
United Setting Professional Modifier None Typical Low $3,388.44 Median $5,128.61 Typical High $7,413.10 | Professional | None | $3,388.44 | $5,128.61 | $7,413.10 |
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 $758.58 Median $758.58 Typical High $2,089.30 | Professional | 55 · Aftercare only | $758.58 | $758.58 | $2,089.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $501.19 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $501.19 | $501.19 | $1,412.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $562.34 Typical High $602.56 | Professional | RR · Rental | $562.34 | $562.34 | $602.56 |
Where Ohio sits
The same service costs 2.3 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
$5,129
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.