How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,479 to $4,074Professionalmedian $1,148 · 10th to 90th $977 to $2,455
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 $1,122.02 Median $1,122.02 Typical High $5,495.41 | Facility | None | $1,122.02 | $1,122.02 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $3,801.89 | Professional | None | $1,122.02 | $1,122.02 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $5,011.87 | Facility | None | $2,187.76 | $2,691.53 | $5,011.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $2,951.21 | Professional | None | $1,023.29 | $1,148.15 | $2,951.21 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $794.33 Median $851.14 Typical High $1,174.90 | Professional | UE · Used equipment | $794.33 | $851.14 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $1,819.70 | Facility | None | $912.01 | $1,380.38 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,621.81 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,071.52 | $1,479.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,071.52 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,778.28 | Professional | None | $977.24 | $1,318.26 | $1,778.28 |
SummaCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,630.78 | Professional | None | $2,344.23 | $2,344.23 | $3,630.78 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $2,344.23 | Facility | None | $954.99 | $1,148.15 | $2,344.23 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,659.59 | Professional | None | $758.58 | $1,148.15 | $1,659.59 |
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 $562.34 Median $562.34 Typical High $1,905.46 | Professional | 52 · Reduced service | $562.34 | $562.34 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $758.58 | Professional | 53 · Discontinued | $223.87 | $223.87 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $575.44 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $380.19 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $380.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | RR · Rental | $104.71 | $104.71 | $112.20 |
Where Ohio sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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
$1,148
HI $2,570RI $1,023
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.