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 $6,025.60 Median $10,232.93 Typical High $13,803.84 | Facility | None | $6,025.60 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,309.57 | Professional | None | $6,025.60 | $6,025.60 | $6,309.57 |
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 $645.65 Median $758.58 Typical High $1,096.48 | Professional | None | $645.65 | $758.58 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $177.83 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $154.88 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $154.88 |
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 $281.84 Median $457.09 Typical High $645.65 | Professional | None | $281.84 | $457.09 | $645.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $645.65 | Professional | None | $281.84 | $457.09 | $645.65 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
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 |
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 $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 53 · Discontinued | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $4,570.88 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $602.56 | $602.56 | $602.56 |
Where Ohio sits
The same service costs 204.2 times more in Wisconsin than in Hawaii. 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· 47th of 51
$759
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.