How much rates vary
Facilitymedian $50,119 · 10th to 90th $30,200 to $83,176Professionalmedian $23,442 · 10th to 90th $21,380 to $47,863
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 $22,908.68 Median $22,908.68 Typical High $64,565.42 | Facility | None | $22,908.68 | $22,908.68 | $64,565.42 |
Aetna Setting Professional Modifier None Typical Low $22,908.68 Median $22,908.68 Typical High $44,668.36 | Professional | None | $22,908.68 | $22,908.68 | $44,668.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $44,668.36 Median $54,954.09 Typical High $102,329.30 | Facility | None | $44,668.36 | $54,954.09 | $102,329.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $23,442.29 Median $23,988.33 Typical High $60,255.96 | Professional | None | $23,442.29 | $23,988.33 | $60,255.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17,782.79 Median $17,782.79 Typical High $24,547.09 | Professional | UE · Used equipment | $17,782.79 | $17,782.79 | $24,547.09 |
CareSource Setting Facility Modifier None Typical Low $19,498.45 Median $29,512.09 Typical High $38,904.51 | Facility | None | $19,498.45 | $29,512.09 | $38,904.51 |
CareSource Setting Professional Modifier None Typical Low $25,703.96 Median $35,481.34 Typical High $52,480.75 | Professional | None | $25,703.96 | $35,481.34 | $52,480.75 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $30,199.52 | Facility | None | $30,199.52 | $30,199.52 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None | $22,387.21 | $22,387.21 | $30,199.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $30,199.52 | Facility | None | $30,199.52 | $30,199.52 | $30,199.52 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None | $22,387.21 | $22,387.21 | $30,199.52 |
Molina Setting Professional Modifier None Typical Low $28,183.83 Median $38,904.51 Typical High $52,480.75 | Professional | None | $28,183.83 | $38,904.51 | $52,480.75 |
SummaCare Setting Professional Modifier None Typical Low $47,863.01 Median $48,977.88 Typical High $75,857.76 | Professional | None | $47,863.01 | $48,977.88 | $75,857.76 |
United Setting Facility Modifier None Typical Low $45,708.82 Median $45,708.82 Typical High $64,565.42 | Facility | None | $45,708.82 | $45,708.82 | $64,565.42 |
United Setting Professional Modifier None Typical Low $15,488.17 Median $23,442.29 Typical High $33,884.42 | Professional | None | $15,488.17 | $23,442.29 | $33,884.42 |
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 $11,481.54 Median $11,481.54 Typical High $22,387.21 | Professional | 52 · Reduced service | $11,481.54 | $11,481.54 | $22,387.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4,570.88 Median $4,570.88 Typical High $8,912.51 | Professional | 53 · Discontinued | $4,570.88 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3,467.37 Median $3,467.37 Typical High $6,760.83 | Professional | 55 · Aftercare only | $3,467.37 | $3,467.37 | $6,760.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2,290.87 Median $2,290.87 Typical High $4,466.84 | Professional | 56 · Pre-op care only | $2,290.87 | $2,290.87 | $4,466.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,398.83 Median $2,398.83 Typical High $2,570.40 | Professional | RR · Rental | $2,398.83 | $2,398.83 | $2,570.40 |
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· 38th of 51
$23,988
HI $47,863NJ $22,387
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.