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 $562.34 Median $3,235.94 Typical High $12,589.25 | Facility | None | $562.34 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $2,630.27 | Professional | None | $144.54 | $181.97 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $251.19 | Professional | None | $117.49 | $154.88 | $251.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $74.13 Median $95.50 Typical High $158.49 | Professional | 62 · Two surgeons | $74.13 | $95.50 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $102.33 | Facility | None | $79.43 | $79.43 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $154.88 Typical High $1,479.11 | Facility | None | $87.10 | $154.88 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $354.81 | Professional | None | $138.04 | $186.21 | $354.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $87.10 Median $154.88 Typical High $1,479.11 | Facility | None | $87.10 | $154.88 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $371.54 | Professional | None | $138.04 | $186.21 | $371.54 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $331.13 | Professional | None | $144.54 | $239.88 | $331.13 |
SummaCare Setting Facility Modifier None Typical Low $46.77 Median $48.98 Typical High $56.23 | Facility | None | $46.77 | $48.98 | $56.23 |
SummaCare Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $245.47 | Professional | None | $131.83 | $186.21 | $245.47 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $323.59 | Professional | None | $134.90 | $181.97 | $323.59 |
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 $72.44 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $72.44 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $28.84 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $109.65 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $21.88 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.45 | $18.20 | $18.20 |
Where Ohio sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 44th of 51
$182
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.