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 $199.53 Median $363.08 Typical High $10,964.78 | Facility | None | $199.53 | $363.08 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $588.84 | Professional | None | $120.23 | $199.53 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $109.65 Typical High $181.97 | Professional | None | $53.70 | $109.65 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $537.03 Typical High $812.83 | Facility | None | $144.54 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $389.05 | Professional | None | $112.20 | $186.21 | $389.05 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $398.11 | Professional | None | $112.20 | $186.21 | $398.11 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $190.55 Typical High $288.40 | Professional | None | $36.31 | $190.55 | $288.40 |
SummaCare Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $257.04 | Professional | None | $114.82 | $169.82 | $257.04 |
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 $104.71 Median $186.21 Typical High $371.54 | Professional | None | $104.71 | $186.21 | $371.54 |
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 $58.88 Median $100.00 Typical High $102.33 | Professional | 52 · Reduced service | $58.88 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $39.81 Typical High $40.74 | Professional | 53 · Discontinued | $23.99 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $151.36 Typical High $154.88 | Professional | 54 · Surgery only | $89.13 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $30.20 Typical High $30.90 | Professional | 55 · Aftercare only | $17.78 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.95 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.02 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $141.25 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $83.18 | $141.25 | $144.54 |
Where Ohio sits
The same service costs 4.5 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· 41st of 51
$182
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.