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 $45.71 Median $10,232.93 Typical High $13,803.84 | Facility | None | $45.71 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $123.03 | Professional | None | $42.66 | $45.71 | $123.03 |
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 $34.67 Median $42.66 Typical High $74.13 | Professional | None | $34.67 | $42.66 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $537.03 Typical High $812.83 | Facility | None | $60.26 | $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 $40.74 Median $48.98 Typical High $87.10 | Professional | None | $40.74 | $48.98 | $87.10 |
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 $40.74 Median $48.98 Typical High $87.10 | Professional | None | $40.74 | $48.98 | $87.10 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $107.15 | Professional | None | $56.23 | $75.86 | $107.15 |
SummaCare Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $64.57 | Professional | None | $42.66 | $53.70 | $64.57 |
United Setting Facility Modifier None Typical Low $97.72 Median $251.19 Typical High $2,398.83 | Facility | None | $97.72 | $251.19 | $2,398.83 |
United Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $91.20 | Professional | None | $35.48 | $51.29 | $91.20 |
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 $21.38 Median $22.91 Typical High $26.30 | Professional | 52 · Reduced service | $21.38 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.12 Typical High $10.47 | Professional | 53 · Discontinued | $8.51 | $9.12 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $33.88 Typical High $38.90 | Professional | 54 · Surgery only | $31.62 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.31 | $6.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.57 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.27 | $4.57 | $5.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $31.62 Typical High $36.31 | Professional | 78 · Unplanned return to OR | $29.51 | $31.62 | $36.31 |
Where Ohio sits
The same service costs 4.6 times more in Alaska than in New York. 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
$51.29
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.