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 $3,801.89 Median $7,943.28 Typical High $13,803.84 | Facility | None | $3,801.89 | $7,943.28 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $5,754.40 Median $19,054.61 Typical High $19,054.61 | Professional | None | $5,754.40 | $19,054.61 | $19,054.61 |
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 $6,165.95 Typical High $10,471.29 | Facility | None | $549.54 | $6,165.95 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $6,165.95 Typical High $9,772.37 | Facility | None | $549.54 | $6,165.95 | $9,772.37 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
SummaCare Setting Facility Modifier None Typical Low $6,606.93 Median $6,918.31 Typical High $7,943.28 | Facility | None | $6,606.93 | $6,918.31 | $7,943.28 |
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 $9,549.93 Median $9,549.93 Typical High $9,549.93 | Professional | 52 · Reduced service | $9,549.93 | $9,549.93 | $9,549.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | 53 · Discontinued | $3,801.89 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13,803.84 Median $14,125.38 Typical High $14,125.38 | Professional | 54 · Surgery only | $13,803.84 | $14,125.38 | $14,125.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 55 · Aftercare only | $2,818.38 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 56 · Pre-op care only | $1,905.46 | $1,905.46 | $1,905.46 |
Where Ohio sits
The same service costs 239.9 times more in Minnesota 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· 32nd of 51
$5,370
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.