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 $676.08 Median $10,232.93 Typical High $13,803.84 | Facility | None | $676.08 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $10,232.93 | Professional | None | $467.74 | $467.74 | $10,232.93 |
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 $1,348.96 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,000.00 Typical High $1,621.81 | Professional | 62 · Two surgeons | $851.14 | $1,000.00 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $257.04 Typical High $407.38 | Professional | 80 · Assistant surgeon | $218.78 | $257.04 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $363.08 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $79,432.82 | Facility | None | $371.54 | $489.78 | $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 $371.54 Median $467.74 Typical High $812.83 | Professional | None | $371.54 | $467.74 | $812.83 |
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 $371.54 Median $467.74 Typical High $831.76 | Professional | None | $371.54 | $467.74 | $831.76 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $173.78 | Professional | None | $120.23 | $151.36 | $173.78 |
SummaCare Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $426.58 | Professional | None | $223.87 | $245.47 | $426.58 |
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 $234.42 Median $407.38 Typical High $660.69 | Professional | None | $234.42 | $407.38 | $660.69 |
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 $346.74 Median $346.74 Typical High $5,888.44 | Professional | 54 · Surgery only | $346.74 | $346.74 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $1,174.90 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $794.33 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $794.33 |
Where Ohio sits
The same service costs 7.1 times more in Wisconsin than in New York. 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· 6th of 51
$1,349
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.