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 $1,862.09 Median $6,918.31 Typical High $12,022.64 | Facility | None | $1,862.09 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $5,754.40 | Professional | None | $1,023.29 | $1,023.29 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,548.13 Typical High $12,302.69 | Facility | None | $1,096.48 | $3,548.13 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,659.59 | Professional | None | $794.33 | $1,000.00 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,513.56 Typical High $2,454.71 | Professional | 50 · Both sides | $1,202.26 | $1,513.56 | $2,454.71 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $4,365.16 | Facility | None | $1,288.25 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,467.37 Typical High $5,888.44 | Facility | None | $549.54 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,318.26 | $1,905.46 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,467.37 Typical High $5,623.41 | Facility | None | $549.54 | $3,467.37 | $5,623.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,318.26 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $645.65 Typical High $1,148.15 | Professional | None | $70.79 | $645.65 | $1,148.15 |
SummaCare Setting Facility Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,905.46 | $1,995.26 | $2,290.87 |
SummaCare Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,288.25 | Professional | None | $891.25 | $1,000.00 | $1,288.25 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,905.46 | Professional | None | $660.69 | $1,096.48 | $1,905.46 |
4 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 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $3,162.28 | Professional | 54 · Surgery only | $758.58 | $758.58 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $630.96 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $426.58 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $2,951.21 |
Where Ohio sits
The same service costs 7.6 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
$851
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.