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 $1,659.59 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,659.59 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $10,232.93 | Professional | None | $1,659.59 | $1,659.59 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $4,677.35 Typical High $21,877.62 | Facility | None | $1,479.11 | $4,677.35 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,778.28 | $2,089.30 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $338.84 Typical High $549.54 | Professional | 80 · Assistant surgeon | $281.84 | $338.84 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $295.12 Typical High $467.74 | Professional | AS · PA/NP assist | $251.19 | $295.12 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $2,691.53 | Facility | None | $501.19 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,548.82 | $1,949.84 | $3,388.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $691.83 Typical High $2,691.53 | Facility | None | $501.19 | $691.83 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,548.82 | $1,949.84 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
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 $1,258.93 Median $1,905.46 Typical High $4,466.84 | Professional | None | $1,258.93 | $1,905.46 | $4,466.84 |
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 $812.83 Median $812.83 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | 53 · Discontinued | $331.13 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $169.82 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $169.82 |
Where Ohio sits
The same service costs 5.2 times more in Alaska than in Maryland. 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· 31st of 51
$2,089
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.