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 $446.68 Median $10,232.93 Typical High $13,803.84 | Facility | None | $446.68 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $1,096.48 | Professional | None | $380.19 | $380.19 | $1,096.48 |
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 $331.13 Median $389.05 Typical High $588.84 | Professional | None | $331.13 | $389.05 | $588.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $208.93 Median $245.47 Typical High $371.54 | Professional | 62 · Two surgeons | $208.93 | $245.47 | $371.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $63.10 Typical High $95.50 | Professional | 80 · Assistant surgeon | $52.48 | $63.10 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $54.95 Typical High $83.18 | Professional | AS · PA/NP assist | $46.77 | $54.95 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $457.09 | Professional | None | $398.11 | $398.11 | $457.09 |
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 $371.54 Median $416.87 Typical High $691.83 | Professional | None | $371.54 | $416.87 | $691.83 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $691.83 | Professional | None | $371.54 | $416.87 | $691.83 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $575.44 | Professional | None | $302.00 | $389.05 | $575.44 |
SummaCare Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | None | $354.81 | $354.81 | $416.87 |
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 $323.59 Median $407.38 Typical High $630.96 | Professional | None | $323.59 | $407.38 | $630.96 |
3 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 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $380.19 | Professional | 54 · Surgery only | $281.84 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $75.86 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $51.29 |
Where Ohio sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$407
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.