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 $1,122.02 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,122.02 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $588.84 Typical High $10,232.93 | Professional | None | $120.23 | $588.84 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $9,332.54 | Facility | None | $1,000.00 | $2,187.76 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $181.97 | Professional | None | $89.13 | $104.71 | $181.97 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.13 Median $16.60 Typical High $30.20 | Professional | 80 · Assistant surgeon | $14.13 | $16.60 | $30.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $12.30 Median $14.45 Typical High $26.92 | Professional | AS · PA/NP assist | $12.30 | $14.45 | $26.92 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $134.90 | Professional | None | $93.33 | $112.20 | $134.90 |
SummaCare Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $199.53 | Professional | None | $104.71 | $109.65 | $199.53 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,388.44 Typical High $5,248.07 | Facility | None | $1,905.46 | $3,388.44 | $5,248.07 |
United Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $371.54 | Professional | None | $120.23 | $158.49 | $371.54 |
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 $60.26 Median $60.26 Typical High $295.12 | Professional | 52 · Reduced service | $60.26 | $60.26 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $117.49 | Professional | 53 · Discontinued | $23.99 | $23.99 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $446.68 | Professional | 54 · Surgery only | $89.13 | $89.13 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $89.13 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $58.88 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $58.88 |
Where Ohio sits
The same service costs 37.2 times more in Oklahoma 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· 49th of 51
$135
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.