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 $204.17 Median $537.03 Typical High $10,715.19 | Facility | None | $204.17 | $537.03 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $1,737.80 | Professional | None | $109.65 | $158.49 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,570.88 | Facility | None | $524.81 | $1,174.90 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $213.80 | Professional | None | $91.20 | $117.49 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $138.04 Typical High $141.25 | Facility | None | $109.65 | $138.04 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $173.78 Typical High $2,398.83 | Facility | None | $107.15 | $173.78 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $288.40 | Professional | None | $104.71 | $154.88 | $288.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $107.15 Median $173.78 Typical High $2,398.83 | Facility | None | $107.15 | $173.78 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $295.12 | Professional | None | $104.71 | $154.88 | $295.12 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $218.78 | Professional | None | $120.23 | $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 $104.71 Median $162.18 Typical High $208.93 | Professional | None | $104.71 | $162.18 | $208.93 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $288.40 | Professional | None | $97.72 | $134.90 | $288.40 |
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 $54.95 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $54.95 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $22.39 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $117.49 Typical High $120.23 | Professional | 54 · Surgery only | $83.18 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $23.99 | Professional | 55 · Aftercare only | $16.60 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.96 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $109.65 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $77.62 | $109.65 | $112.20 |
Where Ohio sits
The same service costs 3.7 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· 39th of 51
$155
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.