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 $4,570.88 Median $10,232.93 Typical High $30,199.52 | Facility | None | $4,570.88 | $10,232.93 | $30,199.52 |
Aetna Setting Professional Modifier None Typical Low $6,606.93 Median $10,964.78 Typical High $12,589.25 | Professional | None | $6,606.93 | $10,964.78 | $12,589.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $7,585.78 Typical High $12,882.50 | Facility | None | $549.54 | $7,585.78 | $12,882.50 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $7,585.78 Typical High $12,022.64 | Facility | None | $549.54 | $7,585.78 | $12,022.64 |
SummaCare Setting Facility Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,897.79 | Facility | None | $4,168.69 | $4,365.16 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $14,454.40 | Facility | None | $1,071.52 | $4,265.80 | $14,454.40 |
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 $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | 52 · Reduced service | $5,495.41 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 53 · Discontinued | $2,187.76 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7,943.28 Median $8,128.31 Typical High $8,128.31 | Professional | 54 · Surgery only | $7,943.28 | $8,128.31 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 55 · Aftercare only | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $1,096.48 | $1,096.48 | $1,096.48 |
Where Ohio sits
The same service costs 229.1 times more in Wyoming than in Montana. 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· 29th of 51
$8,128
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.