How much rates vary
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 $467.74 Median $2,691.53 Typical High $10,964.78 | Facility | None | $467.74 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $3,019.95 | Professional | None | $169.82 | $257.04 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $354.81 | Professional | None | $169.82 | $229.09 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $218.78 Typical High $229.09 | Facility | None | $169.82 | $218.78 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $199.53 Typical High $346.74 | Facility | None | $58.88 | $199.53 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $436.52 | Professional | None | $190.55 | $288.40 | $436.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $199.53 Typical High $338.84 | Facility | None | $58.88 | $199.53 | $338.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $436.52 | Professional | None | $190.55 | $288.40 | $436.52 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $251.19 Typical High $407.38 | Professional | None | $33.88 | $251.19 | $407.38 |
SummaCare Setting Facility Modifier None Typical Low $97.72 Median $102.33 Typical High $114.82 | Facility | None | $97.72 | $102.33 | $114.82 |
SummaCare Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $338.84 | Professional | None | $177.83 | $269.15 | $338.84 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $457.09 | Professional | None | $162.18 | $251.19 | $457.09 |
6 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 $85.11 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $85.11 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $33.88 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $125.89 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $25.12 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.98 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $177.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $117.49 | $177.83 | $177.83 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$251
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.