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 $416.87 Median $10,232.93 Typical High $13,803.84 | Facility | None | $416.87 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $1,737.80 | Professional | None | $316.23 | $416.87 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,023.29 Typical High $4,570.88 | Facility | None | $524.81 | $1,023.29 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $724.44 | Professional | None | $331.13 | $457.09 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $398.11 Typical High $446.68 | Facility | None | $302.00 | $398.11 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $398.11 Typical High $1,479.11 | Facility | None | $309.03 | $398.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $1,000.00 | Professional | None | $323.59 | $446.68 | $1,000.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $309.03 Median $398.11 Typical High $1,479.11 | Facility | None | $309.03 | $398.11 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $1,000.00 | Professional | None | $323.59 | $446.68 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $331.13 Typical High $562.34 | Professional | None | $36.31 | $331.13 | $562.34 |
SummaCare Setting Facility Modifier None Typical Low $162.18 Median $169.82 Typical High $194.98 | Facility | None | $162.18 | $169.82 | $194.98 |
SummaCare Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $549.54 | Professional | None | $323.59 | $467.74 | $549.54 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $812.83 | Professional | None | $323.59 | $489.78 | $812.83 |
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 $158.49 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $83.18 Typical High $97.72 | Professional | 53 · Discontinued | $63.10 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $239.88 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $41.69 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $288.40 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $223.87 | $288.40 | $346.74 |
Where Ohio sits
The same service costs 5.1 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· 46th of 51
$417
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.