How much rates vary
Facilitymedian $7,762 · 10th to 90th $4,677 to $12,882Professionalmedian $3,631 · 10th to 90th $3,467 to $8,128
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 $3,548.13 Median $3,548.13 Typical High $16,595.87 | Facility | None | $3,548.13 | $3,548.13 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $11,481.54 | Professional | None | $3,548.13 | $3,548.13 | $11,481.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $8,511.38 Typical High $15,848.93 | Facility | None | $6,918.31 | $8,511.38 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,630.78 Median $4,265.80 Typical High $9,332.54 | Professional | None | $3,630.78 | $4,265.80 | $9,332.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,754.23 Median $3,090.30 Typical High $3,981.07 | Professional | UE · Used equipment | $2,754.23 | $3,090.30 | $3,981.07 |
CareSource Setting Facility Modifier None Typical Low $4,466.84 Median $6,760.83 Typical High $8,912.51 | Facility | None | $4,466.84 | $6,760.83 | $8,912.51 |
CareSource Setting Professional Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $12,022.64 | Professional | None | $5,754.40 | $8,128.31 | $12,022.64 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $8,709.64 | Professional | None | $4,677.35 | $6,456.54 | $8,709.64 |
SummaCare Setting Professional Modifier None Typical Low $7,413.10 Median $7,585.78 Typical High $11,748.98 | Professional | None | $7,413.10 | $7,585.78 | $11,748.98 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $9,549.93 | Facility | None | $2,884.03 | $3,548.13 | $9,549.93 |
United Setting Professional Modifier None Typical Low $2,398.83 Median $3,630.78 Typical High $5,370.32 | Professional | None | $2,398.83 | $3,630.78 | $5,370.32 |
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 $1,778.28 Median $1,778.28 Typical High $5,754.40 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $5,754.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $2,290.87 | Professional | 53 · Discontinued | $707.95 | $707.95 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $1,698.24 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $1,148.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $426.58 Median $426.58 Typical High $457.09 | Professional | RR · Rental | $426.58 | $426.58 | $457.09 |
Where Ohio sits
The same service costs 2.3 times more in Arkansas than in Vermont. 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· 43rd of 51
$4,074
AR $8,128VT $3,467
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.