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 $1,995.26 Typical High $12,589.25 | Facility | None | $1,000.00 | $1,995.26 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $1,659.59 | Professional | None | $467.74 | $645.65 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $831.76 Typical High $3,388.44 | Facility | None | $380.19 | $831.76 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $831.76 | Professional | None | $467.74 | $588.84 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $154.88 Typical High $602.56 | Facility | None | $120.23 | $154.88 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $213.80 Typical High $2,398.83 | Facility | None | $123.03 | $213.80 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,174.90 | Professional | None | $512.86 | $691.83 | $1,174.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $123.03 Median $208.93 Typical High $2,398.83 | Facility | None | $123.03 | $208.93 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,122.02 | Professional | None | $512.86 | $691.83 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $602.56 Typical High $933.25 | Professional | None | $67.61 | $602.56 | $933.25 |
SummaCare Setting Facility Modifier None Typical Low $66.07 Median $69.18 Typical High $79.43 | Facility | None | $66.07 | $69.18 | $79.43 |
SummaCare Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $831.76 | Professional | None | $446.68 | $575.44 | $831.76 |
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 $398.11 Median $660.69 Typical High $1,096.48 | Professional | None | $398.11 | $660.69 | $1,096.48 |
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 $234.42 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $93.33 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $354.81 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $70.79 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $46.77 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $331.13 | $457.09 | $489.78 |
Where Ohio sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 43rd of 51
$617
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.