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 $1,148.15 Median $1,479.11 Typical High $5,623.41 | Facility | None | $1,148.15 | $1,479.11 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,479.11 | $1,584.89 |
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 $1,122.02 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,412.54 | $2,089.30 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $933.25 Typical High $1,479.11 | Facility | None | $724.44 | $933.25 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $870.96 Typical High $2,398.83 | Facility | None | $549.54 | $870.96 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,621.81 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $870.96 Typical High $2,398.83 | Facility | None | $549.54 | $870.96 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,621.81 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $1,071.52 Typical High $1,905.46 | Professional | None | $141.25 | $1,071.52 | $1,905.46 |
SummaCare Setting Facility Modifier None Typical Low $407.38 Median $436.52 Typical High $489.78 | Facility | None | $407.38 | $436.52 | $489.78 |
SummaCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,412.54 | $1,905.46 |
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 $977.24 Median $1,584.89 Typical High $2,570.40 | Professional | None | $977.24 | $1,584.89 | $2,570.40 |
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 $575.44 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $575.44 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $295.12 Typical High $323.59 | Professional | 53 · Discontinued | $229.09 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $173.78 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $147.91 Typical High $158.49 | Professional | 56 · Pre-op care only | $114.82 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $812.83 | $1,047.13 | $1,122.02 |
Where Ohio sits
The same service costs 5.1 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
$1,288
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.