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 $549.54 Median $3,801.89 Typical High $10,964.78 | Facility | None | $549.54 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $912.01 | Professional | None | $204.17 | $263.03 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,202.26 Typical High $4,786.30 | Facility | None | $562.34 | $1,202.26 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $363.08 | Professional | None | $165.96 | $204.17 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $954.99 Typical High $1,230.27 | Facility | None | $263.03 | $954.99 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,202.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $524.81 | Professional | None | $204.17 | $275.42 | $524.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,202.26 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $524.81 | Professional | None | $204.17 | $281.84 | $524.81 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $436.52 | Professional | None | $204.17 | $302.00 | $436.52 |
SummaCare Setting Facility Modifier None Typical Low $575.44 Median $616.60 Typical High $691.83 | Facility | None | $575.44 | $616.60 | $691.83 |
SummaCare Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $354.81 | Professional | None | $194.98 | $275.42 | $354.81 |
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 $194.98 Median $263.03 Typical High $524.81 | Professional | None | $194.98 | $263.03 | $524.81 |
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 $102.33 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $102.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $41.69 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $154.88 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $30.90 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $20.42 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $186.21 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $144.54 | $186.21 | $186.21 |
Where Ohio sits
The same service costs 4.7 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
$275
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.