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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $5,754.40 | Professional | None | $1,230.27 | $1,230.27 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $3,890.45 Typical High $19,054.61 | Facility | None | $1,000.00 | $3,890.45 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,995.26 | Professional | None | $977.24 | $1,230.27 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,819.70 Typical High $2,951.21 | Professional | 50 · Both sides | $1,445.44 | $1,819.70 | $2,951.21 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $9,772.37 Typical High $12,589.25 | Facility | None | $1,584.89 | $9,772.37 | $12,589.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $9,120.11 Typical High $19,498.45 | Facility | None | $549.54 | $9,120.11 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,621.81 | $2,344.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $9,120.11 Typical High $19,498.45 | Facility | None | $549.54 | $9,120.11 | $19,498.45 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,621.81 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $794.33 Typical High $1,412.54 | Professional | None | $107.15 | $794.33 | $1,412.54 |
SummaCare Setting Facility Modifier None Typical Low $4,466.84 Median $4,677.35 Typical High $5,248.07 | Facility | None | $4,466.84 | $4,677.35 | $5,248.07 |
SummaCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,202.26 | $1,548.82 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $13,182.57 | Facility | None | $912.01 | $3,388.44 | $13,182.57 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $2,290.87 | Professional | None | $794.33 | $1,348.96 | $2,290.87 |
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 $933.25 Median $933.25 Typical High $3,801.89 | Professional | 54 · Surgery only | $933.25 | $933.25 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $758.58 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $501.19 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $3,548.13 |
Where Ohio sits
The same service costs 8.1 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
$1,023
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.