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 $181.97 Median $436.52 Typical High $10,715.19 | Facility | None | $181.97 | $436.52 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $398.11 | Professional | None | $100.00 | $117.49 | $398.11 |
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 $81.28 Median $102.33 Typical High $162.18 | Professional | None | $81.28 | $102.33 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $104.71 Typical High $138.04 | Facility | None | $81.28 | $104.71 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $602.56 | Facility | None | $66.07 | $104.71 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $208.93 | Professional | None | $112.20 | $134.90 | $208.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $616.60 | Facility | None | $66.07 | $104.71 | $616.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $204.17 | Professional | None | $112.20 | $134.90 | $204.17 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $186.21 | Professional | None | $89.13 | $123.03 | $186.21 |
SummaCare Setting Facility Modifier None Typical Low $47.86 Median $50.12 Typical High $57.54 | Facility | None | $47.86 | $50.12 | $57.54 |
SummaCare Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $162.18 | Professional | None | $107.15 | $134.90 | $162.18 |
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 $75.86 Median $117.49 Typical High $194.98 | Professional | None | $75.86 | $117.49 | $194.98 |
3 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 $75.86 Median $87.10 Typical High $100.00 | Professional | 54 · Surgery only | $75.86 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $81.28 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $70.79 | $81.28 | $93.33 |
Ambetter Setting Professional Modifier GZ · Expected denial Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | GZ · Expected denial | $181.97 | $181.97 | $181.97 |
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· 40th of 51
$126
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.