How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,778 to $6,457Professionalmedian $1,820 · 10th to 90th $1,288 to $3,981
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 $1,778.28 Median $1,778.28 Typical High $7,762.47 | Facility | None | $1,778.28 | $1,778.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $5,370.32 | Professional | None | $1,778.28 | $1,778.28 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,265.80 Typical High $7,943.28 | Facility | None | $3,467.37 | $4,265.80 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $4,677.35 | Professional | None | $1,698.24 | $1,819.70 | $4,677.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,318.26 Median $1,380.38 Typical High $1,949.84 | Professional | UE · Used equipment | $1,318.26 | $1,380.38 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,412.54 | $2,137.96 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $3,890.45 | Professional | None | $1,862.09 | $2,570.40 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $4,265.80 | Professional | None | $2,290.87 | $3,162.28 | $4,265.80 |
SummaCare Setting Professional Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $5,888.44 | Professional | None | $3,715.35 | $3,801.89 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $3,890.45 | Facility | None | $1,621.81 | $1,862.09 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,819.70 | $2,630.27 |
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 $891.25 Median $891.25 Typical High $2,691.53 | Professional | 52 · Reduced service | $891.25 | $891.25 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $1,071.52 | Professional | 53 · Discontinued | $354.81 | $354.81 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $794.33 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $537.03 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $537.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | RR · Rental | $173.78 | $173.78 | $190.55 |
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· 29th of 51
$1,820
HI $4,169DE $1,288
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.