How much rates vary
Facilitymedian $10,965 · 10th to 90th $6,607 to $18,197Professionalmedian $5,012 · 10th to 90th $4,571 to $10,715
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 $4,897.79 Median $4,897.79 Typical High $18,197.01 | Facility | None | $4,897.79 | $4,897.79 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $12,589.25 | Professional | None | $4,897.79 | $4,897.79 | $12,589.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $21,877.62 | Facility | None | $9,772.37 | $12,022.64 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $5,011.87 Typical High $12,882.50 | Professional | None | $4,897.79 | $5,011.87 | $12,882.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,630.78 Median $3,801.89 Typical High $5,128.61 | Professional | UE · Used equipment | $3,630.78 | $3,801.89 | $5,128.61 |
CareSource Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $7,943.28 | Facility | None | $3,981.07 | $6,025.60 | $7,943.28 |
CareSource Setting Professional Modifier None Typical Low $5,248.07 Median $7,244.36 Typical High $10,715.19 | Professional | None | $5,248.07 | $7,244.36 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,606.93 | Professional | None | $4,786.30 | $4,786.30 | $6,606.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,606.93 | Professional | None | $4,786.30 | $4,786.30 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $6,025.60 Median $8,128.31 Typical High $11,220.18 | Professional | None | $6,025.60 | $8,128.31 | $11,220.18 |
SummaCare Setting Professional Modifier None Typical Low $10,232.93 Median $10,471.29 Typical High $16,218.10 | Professional | None | $10,232.93 | $10,471.29 | $16,218.10 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $10,964.78 | Facility | None | $3,801.89 | $4,466.84 | $10,964.78 |
United Setting Professional Modifier None Typical Low $3,388.44 Median $5,011.87 Typical High $7,244.36 | Professional | None | $3,388.44 | $5,011.87 | $7,244.36 |
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 $2,454.71 Median $2,454.71 Typical High $6,309.57 | Professional | 52 · Reduced service | $2,454.71 | $2,454.71 | $6,309.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $977.24 Typical High $2,511.89 | Professional | 53 · Discontinued | $977.24 | $977.24 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $741.31 Median $741.31 Typical High $1,862.09 | Professional | 55 · Aftercare only | $741.31 | $741.31 | $1,862.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $489.78 Typical High $1,258.93 | Professional | 56 · Pre-op care only | $489.78 | $489.78 | $1,258.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $489.78 Typical High $524.81 | Professional | RR · Rental | $489.78 | $489.78 | $524.81 |
Where Ohio sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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
$5,012
MT $10,000PA $4,786
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.