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 $407.38 Median $3,235.94 Typical High $12,589.25 | Facility | None | $407.38 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $169.82 | Professional | None | $114.82 | $125.89 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $912.01 Typical High $3,311.31 | Facility | None | $371.54 | $912.01 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $165.96 | Professional | None | $81.28 | $85.11 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $154.88 Typical High $177.83 | Facility | None | $138.04 | $154.88 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $263.03 Typical High $1,479.11 | Facility | None | $147.91 | $263.03 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $251.19 | Professional | None | $128.82 | $162.18 | $251.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $147.91 Median $263.03 Typical High $1,479.11 | Facility | None | $147.91 | $263.03 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $245.47 | Professional | None | $128.82 | $162.18 | $245.47 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $234.42 | Professional | None | $117.49 | $158.49 | $234.42 |
SummaCare Setting Facility Modifier None Typical Low $79.43 Median $83.18 Typical High $93.33 | Facility | None | $79.43 | $83.18 | $93.33 |
SummaCare Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $181.97 | Professional | None | $120.23 | $151.36 | $181.97 |
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 $95.50 Median $151.36 Typical High $257.04 | Professional | None | $95.50 | $151.36 | $257.04 |
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 $61.66 Median $72.44 Typical High $77.62 | Professional | 52 · Reduced service | $61.66 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $24.55 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $109.65 Typical High $117.49 | Professional | 54 · Surgery only | $93.33 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $23.44 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $102.33 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $87.10 | $102.33 | $109.65 |
Where Ohio sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 39th of 51
$151
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.