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 $1,000.00 Median $1,288.25 Typical High $4,786.30 | Facility | None | $1,000.00 | $1,288.25 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,288.25 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $4,677.35 | Facility | None | $524.81 | $1,288.25 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,819.70 | Professional | None | $977.24 | $1,230.27 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $1,288.25 | Facility | None | $645.65 | $831.76 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $794.33 Typical High $2,398.83 | Facility | None | $549.54 | $794.33 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,412.54 | $2,290.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $794.33 Typical High $2,398.83 | Facility | None | $549.54 | $794.33 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,412.54 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $977.24 Typical High $1,659.59 | Professional | None | $141.25 | $977.24 | $1,659.59 |
SummaCare Setting Facility Modifier None Typical Low $371.54 Median $389.05 Typical High $436.52 | Facility | None | $371.54 | $389.05 | $436.52 |
SummaCare Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,659.59 | Professional | None | $933.25 | $1,230.27 | $1,659.59 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,412.54 Typical High $2,290.87 | Professional | None | $851.14 | $1,412.54 | $2,290.87 |
5 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 $501.19 Median $645.65 Typical High $707.95 | Professional | 52 · Reduced service | $501.19 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $263.03 Typical High $281.84 | Professional | 53 · Discontinued | $199.53 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $151.36 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $128.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $100.00 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $912.01 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $691.83 | $912.01 | $977.24 |
Where Ohio sits
The same service costs 5.0 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· 48th of 51
$1,148
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.