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 $144.54 Median $10,232.93 Typical High $13,803.84 | Facility | None | $144.54 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $380.19 | Professional | None | $100.00 | $144.54 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $151.36 | Professional | None | $64.57 | $89.13 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $125.89 Typical High $131.83 | Facility | None | $102.33 | $125.89 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $199.53 Typical High $1,479.11 | Facility | None | $109.65 | $199.53 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $288.40 | Professional | None | $97.72 | $147.91 | $288.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $109.65 Median $194.98 Typical High $1,479.11 | Facility | None | $109.65 | $194.98 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $295.12 | Professional | None | $97.72 | $147.91 | $295.12 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $218.78 | Professional | None | $125.89 | $162.18 | $218.78 |
SummaCare Setting Facility Modifier None Typical Low $58.88 Median $61.66 Typical High $70.79 | Facility | None | $58.88 | $61.66 | $70.79 |
SummaCare Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $199.53 | Professional | None | $95.50 | $151.36 | $199.53 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $263.03 | Professional | None | $85.11 | $138.04 | $263.03 |
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 $50.12 Median $72.44 Typical High $74.13 | Professional | 52 · Reduced service | $50.12 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $28.84 Typical High $29.51 | Professional | 53 · Discontinued | $19.95 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $109.65 Typical High $112.20 | Professional | 54 · Surgery only | $75.86 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.88 Typical High $22.39 | Professional | 55 · Aftercare only | $15.14 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.45 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.00 | $14.45 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $102.33 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $70.79 | $102.33 | $104.71 |
Where Ohio sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 46th of 51
$145
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.