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 $426.58 Median $10,232.93 Typical High $13,803.84 | Facility | None | $426.58 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $4,168.69 | Professional | None | $363.08 | $363.08 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $2,630.27 Typical High $7,762.47 | Facility | None | $831.76 | $2,630.27 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,890.45 | Professional | None | $2,089.30 | $2,454.71 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,548.82 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,318.26 | $1,548.82 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $389.05 Typical High $630.96 | Professional | 80 · Assistant surgeon | $331.13 | $389.05 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $346.74 Typical High $549.54 | Professional | AS · PA/NP assist | $288.40 | $346.74 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $398.11 Typical High $79,432.82 | Facility | None | $309.03 | $398.11 | $79,432.82 |
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 $323.59 Median $398.11 Typical High $707.95 | Professional | None | $323.59 | $398.11 | $707.95 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $724.44 | Professional | None | $323.59 | $398.11 | $724.44 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $295.12 | Professional | None | $181.97 | $223.87 | $295.12 |
SummaCare Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | None | $338.84 | $338.84 | $457.09 |
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 $281.84 Median $363.08 Typical High $741.31 | Professional | None | $281.84 | $363.08 | $741.31 |
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 $269.15 Median $269.15 Typical High $2,238.72 | Professional | 54 · Surgery only | $269.15 | $269.15 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $446.68 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $302.00 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $302.00 |
Where Ohio sits
The same service costs 9.8 times more in Indiana than in Hawaii. 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· 3rd of 51
$1,862
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.