How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,950 to $5,370Professionalmedian $1,479 · 10th to 90th $1,380 to $3,090
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 $6,309.57 | Facility | None | $1,479.11 | $1,479.11 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $4,365.16 | Professional | None | $1,479.11 | $1,479.11 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $6,606.93 | Facility | None | $2,884.03 | $3,630.78 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $3,311.31 | Professional | None | $1,380.38 | $1,479.11 | $3,311.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $1,122.02 Typical High $1,513.56 | Professional | UE · Used equipment | $1,047.13 | $1,122.02 | $1,513.56 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $2,290.87 | Facility | None | $1,148.15 | $1,737.80 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,513.56 | $2,089.30 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,445.44 | $1,949.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,445.44 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,659.59 | $2,238.72 | $3,019.95 |
SummaCare Setting Professional Modifier None Typical Low $3,090.30 Median $3,162.28 Typical High $4,897.79 | Professional | None | $3,090.30 | $3,162.28 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $3,162.28 | Facility | None | $1,096.48 | $1,258.93 | $3,162.28 |
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 $741.31 Median $741.31 Typical High $2,187.76 | Professional | 52 · Reduced service | $741.31 | $741.31 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $870.96 | Professional | 53 · Discontinued | $295.12 | $295.12 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $660.69 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $436.52 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $436.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | RR · Rental | $138.04 | $138.04 | $151.36 |
Where Ohio sits
The same service costs 2.4 times more in Minnesota 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· 31st of 51
$1,479
MN $2,951DC $1,230
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.