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 $2,137.96 Median $4,365.16 Typical High $12,589.25 | Facility | None | $2,137.96 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $2,238.72 Typical High $3,715.35 | Professional | None | $223.87 | $2,238.72 | $3,715.35 |
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 $213.80 Median $741.31 Typical High $2,570.40 | Professional | None | $213.80 | $741.31 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $933.25 Typical High $1,202.26 | Facility | None | $275.42 | $933.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $4,677.35 | Facility | None | $602.56 | $1,122.02 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $1,698.24 Typical High $3,311.31 | Professional | None | $213.80 | $1,698.24 | $3,311.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $4,677.35 | Facility | None | $602.56 | $1,122.02 | $4,677.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $213.80 Median $1,698.24 Typical High $3,311.31 | Professional | None | $213.80 | $1,698.24 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $2,089.30 Typical High $3,388.44 | Professional | None | $190.55 | $2,089.30 | $3,388.44 |
SummaCare Setting Facility Modifier None Typical Low $512.86 Median $537.03 Typical High $616.60 | Facility | None | $512.86 | $537.03 | $616.60 |
SummaCare Setting Professional Modifier None Typical Low $208.93 Median $1,949.84 Typical High $2,691.53 | Professional | None | $208.93 | $1,949.84 | $2,691.53 |
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 $234.42 Median $1,380.38 Typical High $3,467.37 | Professional | None | $234.42 | $1,380.38 | $3,467.37 |
2 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 $165.96 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $165.96 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $154.88 | $1,548.82 | $1,548.82 |
Where Ohio sits
The same service costs 7.1 times more in Oregon 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· 27th of 51
$1,585
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.