How much rates vary
Facilitymedian $11,749 · 10th to 90th $7,244 to $19,498Professionalmedian $5,370 · 10th to 90th $4,898 to $11,749
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 $5,248.07 Median $5,248.07 Typical High $20,892.96 | Facility | None | $5,248.07 | $5,248.07 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $14,454.40 | Professional | None | $5,248.07 | $5,248.07 | $14,454.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $12,882.50 Typical High $23,442.29 | Facility | None | $10,232.93 | $12,882.50 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,370.32 Median $5,623.41 Typical High $13,803.84 | Professional | None | $5,370.32 | $5,623.41 | $13,803.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,073.80 Median $4,265.80 Typical High $5,495.41 | Professional | UE · Used equipment | $4,073.80 | $4,265.80 | $5,495.41 |
CareSource Setting Facility Modifier None Typical Low $5,370.32 Median $8,128.31 Typical High $10,715.19 | Facility | None | $5,370.32 | $8,128.31 | $10,715.19 |
CareSource Setting Professional Modifier None Typical Low $7,079.46 Median $9,772.37 Typical High $14,454.40 | Professional | None | $7,079.46 | $9,772.37 | $14,454.40 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $7,244.36 | Professional | None | $5,248.07 | $5,248.07 | $7,244.36 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $7,244.36 | Professional | None | $5,248.07 | $5,248.07 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $6,606.93 Median $8,912.51 Typical High $12,022.64 | Professional | None | $6,606.93 | $8,912.51 | $12,022.64 |
SummaCare Setting Professional Modifier None Typical Low $10,964.78 Median $11,220.18 Typical High $17,378.01 | Professional | None | $10,964.78 | $11,220.18 | $17,378.01 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $12,589.25 | Facility | None | $4,365.16 | $5,128.61 | $12,589.25 |
United Setting Professional Modifier None Typical Low $3,630.78 Median $5,370.32 Typical High $7,762.47 | Professional | None | $3,630.78 | $5,370.32 | $7,762.47 |
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 $2,630.27 Median $2,630.27 Typical High $7,244.36 | Professional | 52 · Reduced service | $2,630.27 | $2,630.27 | $7,244.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,047.13 Typical High $2,884.03 | Professional | 53 · Discontinued | $1,047.13 | $1,047.13 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $794.33 Typical High $2,187.76 | Professional | 55 · Aftercare only | $794.33 | $794.33 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $524.81 Typical High $1,445.44 | Professional | 56 · Pre-op care only | $524.81 | $524.81 | $1,445.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $562.34 Typical High $602.56 | Professional | RR · Rental | $562.34 | $562.34 | $602.56 |
Where Ohio sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 37th of 51
$5,623
HI $11,220NJ $5,248
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.