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 $104.71 Median $10,232.93 Typical High $13,803.84 | Facility | None | $104.71 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $229.09 | Professional | None | $81.28 | $104.71 | $229.09 |
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 $72.44 Median $102.33 Typical High $162.18 | Professional | None | $72.44 | $102.33 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $537.03 Typical High $812.83 | Facility | None | $114.82 | $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 $77.62 Median $104.71 Typical High $208.93 | Professional | None | $77.62 | $104.71 | $208.93 |
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 $79.43 Median $107.15 Typical High $199.53 | Professional | None | $79.43 | $107.15 | $199.53 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $158.49 | Professional | None | $85.11 | $112.20 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $141.25 | Professional | None | $79.43 | $120.23 | $141.25 |
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 $77.62 Median $114.82 Typical High $204.17 | Professional | None | $77.62 | $114.82 | $204.17 |
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 $40.74 Median $52.48 Typical High $54.95 | Professional | 52 · Reduced service | $40.74 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.38 Typical High $21.88 | Professional | 53 · Discontinued | $16.22 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $79.43 Typical High $83.18 | Professional | 54 · Surgery only | $60.26 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.85 Typical High $16.60 | Professional | 55 · Aftercare only | $12.02 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.47 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.13 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $74.13 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $56.23 | $74.13 | $77.62 |
Where Ohio sits
The same service costs 3.8 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· 44th of 51
$110
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.