How much rates vary
Facilitymedian $4,365 · 10th to 90th $2,570 to $7,943Professionalmedian $2,570 · 10th to 90th $2,455 to $3,236
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 $2,570.40 Median $2,570.40 Typical High $8,709.64 | Facility | None | $2,570.40 | $2,570.40 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,570.40 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $3,890.45 Typical High $7,585.78 | Facility | None | $2,630.27 | $3,890.45 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,548.13 | Professional | None | $2,570.40 | $2,570.40 | $3,548.13 |
CareSource Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
CareSource Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,311.31 | Professional | None | $2,454.71 | $2,454.71 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $5,495.41 Typical High $8,317.64 | Facility | None | $4,786.30 | $5,495.41 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3,467.37 Median $5,495.41 Typical High $7,244.36 | Facility | None | $3,467.37 | $5,495.41 | $7,244.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,884.03 | Professional | None | $2,570.40 | $2,570.40 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $3,162.28 | Professional | None | $2,454.71 | $2,691.53 | $3,162.28 |
SummaCare Setting Professional Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $3,162.28 | Professional | None | $2,570.40 | $2,691.53 | $3,162.28 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,511.89 | $2,754.23 |
5 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 $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | 53 · Discontinued | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $281.84 |
Where Ohio sits
Rates are fairly even across states for this service. 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· 30th of 51
$2,570
AK $3,020KS $2,570
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.