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 $870.96 Median $4,365.16 Typical High $12,589.25 | Facility | None | $870.96 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $3,311.31 | Professional | None | $234.42 | $302.00 | $3,311.31 |
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 $229.09 Median $309.03 Typical High $467.74 | Professional | None | $229.09 | $309.03 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $234.42 Typical High $331.13 | Facility | None | $181.97 | $234.42 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $204.17 Typical High $407.38 | Facility | None | $58.88 | $204.17 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $575.44 | Professional | None | $229.09 | $302.00 | $575.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $204.17 Typical High $407.38 | Facility | None | $58.88 | $204.17 | $407.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $575.44 | Professional | None | $229.09 | $302.00 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $309.03 Typical High $467.74 | Professional | None | $33.88 | $309.03 | $467.74 |
SummaCare Setting Facility Modifier None Typical Low $97.72 Median $104.71 Typical High $117.49 | Facility | None | $97.72 | $104.71 | $117.49 |
SummaCare Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $416.87 | Professional | None | $229.09 | $346.74 | $416.87 |
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 $229.09 Median $331.13 Typical High $588.84 | Professional | None | $229.09 | $331.13 | $588.84 |
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 $117.49 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $117.49 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $46.77 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $229.09 Typical High $239.88 | Professional | 54 · Surgery only | $173.78 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $45.71 Typical High $47.86 | Professional | 55 · Aftercare only | $34.67 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $23.44 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $213.80 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $162.18 | $213.80 | $223.87 |
Where Ohio sits
The same service costs 4.0 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· 42nd of 51
$309
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.