How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,413 to $5,370Professionalmedian $1,514 · 10th to 90th $1,047 to $3,162
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 $1,479.11 Median $1,479.11 Typical High $5,623.41 | Facility | None | $1,479.11 | $1,479.11 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $3,890.45 | Professional | None | $1,479.11 | $1,479.11 | $3,890.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $6,606.93 | Facility | None | $2,884.03 | $3,548.13 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $3,890.45 | Professional | None | $1,380.38 | $1,513.56 | $3,890.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,023.29 Median $1,122.02 Typical High $1,584.89 | Professional | UE · Used equipment | $1,023.29 | $1,122.02 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,148.15 | $1,698.24 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,479.11 | $2,041.74 | $3,090.30 |
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 $1,047.13 Median $1,047.13 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,047.13 | $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 $1,047.13 Median $1,047.13 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,047.13 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,737.80 | $2,344.23 |
SummaCare Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $4,786.30 | Professional | None | $3,090.30 | $3,090.30 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $3,090.30 | Facility | None | $1,348.96 | $1,513.56 | $3,090.30 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,513.56 | $2,187.76 |
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 $724.44 Median $724.44 Typical High $1,949.84 | Professional | 52 · Reduced service | $724.44 | $724.44 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $776.25 | Professional | 53 · Discontinued | $295.12 | $295.12 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $575.44 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $389.05 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | RR · Rental | $138.04 | $138.04 | $147.91 |
Where Ohio sits
The same service costs 3.2 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· 27th of 51
$1,514
HI $3,388DE $1,047
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.