How much rates vary
Facilitymedian $4,677 · 10th to 90th $562 to $12,589Professionalmedian $537 · 10th to 90th $389 to $1,122
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 $7,943.28 Typical High $12,589.25 | Facility | None | $2,570.40 | $7,943.28 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $9,332.54 | Professional | None | $436.52 | $436.52 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,803.84 | Facility | None | $891.25 | $6,606.93 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $954.99 | Professional | None | $457.09 | $630.96 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $954.99 Typical High $1,445.44 | Professional | 50 · Both sides | $676.08 | $954.99 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $398.11 Typical High $602.56 | Professional | 62 · Two surgeons | $288.40 | $398.11 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $100.00 Typical High $158.49 | Professional | 80 · Assistant surgeon | $72.44 | $100.00 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $89.13 Typical High $134.90 | Professional | AS · PA/NP assist | $63.10 | $89.13 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $1,202.26 | Professional | None | $398.11 | $501.19 | $1,202.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $1,202.26 | Professional | None | $398.11 | $501.19 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $537.03 | Professional | None | $354.81 | $436.52 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $933.25 | Professional | None | $371.54 | $407.38 | $933.25 |
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 $426.58 Median $741.31 Typical High $1,174.90 | Professional | None | $426.58 | $741.31 | $1,174.90 |
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 $218.78 Median $218.78 Typical High $977.24 | Professional | 52 · Reduced service | $218.78 | $218.78 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $389.05 | Professional | 53 · Discontinued | $87.10 | $87.10 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $1,479.11 | Professional | 54 · Surgery only | $323.59 | $323.59 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $295.12 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $194.98 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $194.98 |
Where Ohio sits
The same service costs 3.7 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· 39th of 51
$631
WI $1,622NY $437
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.