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 $407.38 Median $10,232.93 Typical High $13,803.84 | Facility | None | $407.38 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $1,047.13 | Professional | None | $309.03 | $407.38 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $575.44 | Professional | None | $257.04 | $346.74 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $812.83 | Facility | None | $416.87 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $724.44 | Professional | None | $288.40 | $398.11 | $724.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $707.95 | Professional | None | $288.40 | $398.11 | $707.95 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $323.59 Typical High $575.44 | Professional | None | $36.31 | $323.59 | $575.44 |
SummaCare Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $549.54 | Professional | None | $316.23 | $467.74 | $549.54 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $776.25 | Professional | None | $288.40 | $426.58 | $776.25 |
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 $154.88 Median $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $154.88 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $81.28 Typical High $85.11 | Professional | 53 · Discontinued | $61.66 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $229.09 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $45.71 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $30.90 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $213.80 | $281.84 | $302.00 |
Where Ohio sits
The same service costs 4.7 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· 47th of 51
$372
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.