How much rates vary
Facilitymedian $257 · 10th to 90th $170 to $468Professionalmedian $123 · 10th to 90th $112 to $245
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 $117.49 Median $117.49 Typical High $660.69 | Facility | None | $117.49 | $117.49 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $467.74 | Professional | None | $117.49 | $117.49 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $288.40 Typical High $524.81 | Facility | None | $229.09 | $288.40 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $263.03 | Professional | None | $117.49 | $123.03 | $263.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $93.33 Typical High $123.03 | Professional | UE · Used equipment | $89.13 | $93.33 | $123.03 |
Aultcare Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $204.17 | Facility | None | $102.33 | $154.88 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $275.42 | Professional | None | $131.83 | $181.97 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $239.88 | Professional | None | $131.83 | $177.83 | $239.88 |
SummaCare Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $389.05 | Professional | None | $245.47 | $251.19 | $389.05 |
United Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $275.42 | Facility | None | $107.15 | $134.90 | $275.42 |
United Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $173.78 | Professional | None | $79.43 | $120.23 | $173.78 |
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 $58.88 Median $58.88 Typical High $229.09 | Professional | 52 · Reduced service | $58.88 | $58.88 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $93.33 | Professional | 53 · Discontinued | $23.44 | $23.44 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $69.18 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $46.77 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $46.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $13.49 | Professional | RR · Rental | $12.30 | $12.30 | $13.49 |
Where Ohio sits
The same service costs 2.7 times more in Hawaii 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· 49th of 51
$123
HI $295DC $110
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.