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 $11.48 Median $11.48 Typical High $58.88 | Facility | None | $11.48 | $11.48 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $54.95 | Professional | None | $11.48 | $11.48 | $54.95 |
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 $6.92 Median $10.47 Typical High $22.39 | Professional | None | $6.92 | $10.47 | $22.39 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $8.51 Median $10.23 Typical High $21.38 | Professional | 50 · Both sides | $8.51 | $10.23 | $21.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $4.07 Median $5.62 Typical High $7.59 | Professional | 62 · Two surgeons | $4.07 | $5.62 | $7.59 |
CareSource Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
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 $11.22 Median $12.88 Typical High $31.62 | Professional | None | $11.22 | $12.88 | $31.62 |
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 $11.22 Median $12.88 Typical High $26.92 | Professional | None | $11.22 | $12.88 | $26.92 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | None | $50.12 | $50.12 | $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 $10.72 Median $10.72 Typical High $17.78 | Professional | None | $10.72 | $10.72 | $17.78 |
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 $11.48 Median $14.13 Typical High $27.54 | Professional | None | $11.48 | $14.13 | $27.54 |
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 $5.75 Median $5.75 Typical High $27.54 | Professional | 52 · Reduced service | $5.75 | $5.75 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $10.96 | Professional | 53 · Discontinued | $2.29 | $2.29 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $8.32 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $5.50 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $5.50 |
Where Ohio sits
The same service costs 12.3 times more in Florida 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· 40th of 51
$15.49
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.