How much rates vary
Facilitymedian $398 · 10th to 90th $52 to $955Professionalmedian $209 · 10th to 90th $45 to $275
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $44.67 Median $389.05 Typical High $446.68 | Facility | None | $44.67 | $389.05 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $346.74 | Professional | None | $44.67 | $44.67 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $257.04 | Professional | None | $177.83 | $208.93 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $64.57 Typical High $194.98 | Facility | None | $52.48 | $64.57 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $363.08 | Professional | None | $147.91 | $213.80 | $363.08 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,290.87 | Facility | None | $912.01 | $954.99 | $2,290.87 |
United Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $70.79 | Professional | None | $39.81 | $52.48 | $70.79 |
8 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier AA · Anesthesiologist Typical Low $218.78 Median $218.78 Typical High $467.74 | Professional | AA · Anesthesiologist | $218.78 | $218.78 | $467.74 |
Ambetter Setting Professional Modifier QK · Directing 2–4 cases Typical Low $147.91 Median $234.42 Typical High $257.04 | Professional | QK · Directing 2–4 cases | $147.91 | $234.42 | $257.04 |
Ambetter Setting Professional Modifier QX · CRNA, directed Typical Low $128.82 Median $204.17 Typical High $234.42 | Professional | QX · CRNA, directed | $128.82 | $204.17 | $234.42 |
Ambetter Setting Professional Modifier QY · Directing one CRNA Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | QY · Directing one CRNA | $77.62 | $77.62 | $77.62 |
Ambetter Setting Professional Modifier QZ · CRNA, independent Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | QZ · CRNA, independent | $177.83 | $245.47 | $245.47 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P3 · Severe systemic disease Typical Low $181.97 Median $281.84 Typical High $371.54 | Professional | P3 · Severe systemic disease | $181.97 | $281.84 | $371.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $218.78 Median $338.84 Typical High $446.68 | Professional | P4 · Life-threatening disease | $218.78 | $338.84 | $446.68 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $251.19 Median $398.11 Typical High $524.81 | Professional | P5 · Not expected to survive without surgery | $251.19 | $398.11 | $524.81 |