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 $45.71 Median $45.71 Typical High $758.58 | Facility | None | $45.71 | $45.71 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $707.95 | Professional | None | $45.71 | $45.71 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $831.76 Typical High $3,388.44 | Facility | None | $380.19 | $831.76 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $7.08 Typical High $63.10 | Professional | None | $6.61 | $7.08 | $63.10 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $8.51 Median $10.23 Typical High $81.28 | Professional | 50 · Both sides | $8.51 | $10.23 | $81.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $4.07 Median $5.62 Typical High $28.84 | Professional | 62 · Two surgeons | $4.07 | $5.62 | $28.84 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $1,659.59 | Facility | None | $398.11 | $562.34 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $104.71 | Professional | None | $43.65 | $51.29 | $104.71 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $602.56 Typical High $1,659.59 | Facility | None | $398.11 | $602.56 | $1,659.59 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $104.71 | Professional | None | $43.65 | $51.29 | $104.71 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $39.81 Typical High $60.26 | Professional | None | $23.44 | $39.81 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $251.19 Median $263.03 Typical High $302.00 | Facility | None | $251.19 | $263.03 | $302.00 |
SummaCare Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $69.18 | Professional | None | $41.69 | $41.69 | $69.18 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $109.65 | Professional | None | $44.67 | $54.95 | $109.65 |
4 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 $22.91 Median $22.91 Typical High $346.74 | Professional | 52 · Reduced service | $22.91 | $22.91 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $141.25 | Professional | 53 · Discontinued | $9.12 | $9.12 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $104.71 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $70.79 |
Where Ohio sits
The same service costs 4.7 times more in Wisconsin than in Kentucky. 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· 48th of 51
$50.12
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.