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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $4,677.35 | Professional | None | $912.01 | $912.01 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,311.31 Typical High $6,309.57 | Facility | None | $741.31 | $3,311.31 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,584.89 | Professional | None | $691.83 | $870.96 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,089.30 | Professional | None | $977.24 | $1,288.25 | $2,089.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,089.30 | Professional | None | $977.24 | $1,288.25 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $870.96 Typical High $1,412.54 | Professional | None | $120.23 | $870.96 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,023.29 | $1,513.56 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $2,454.71 | Professional | None | $933.25 | $1,258.93 | $2,454.71 |
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 $457.09 Median $457.09 Typical High $1,698.24 | Professional | 52 · Reduced service | $457.09 | $457.09 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $676.08 | Professional | 53 · Discontinued | $181.97 | $181.97 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $2,511.89 | Professional | 54 · Surgery only | $676.08 | $676.08 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $501.19 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $338.84 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $2,344.23 |
Where Ohio sits
The same service costs 7.4 times more in Alaska 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· 47th of 51
$955
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.