How much rates vary
Facilitymedian $3,631 · 10th to 90th $631 to $14,125Professionalmedian $214 · 10th to 90th $148 to $324
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 $147.91 Median $933.25 Typical High $7,244.36 | Facility | None | $147.91 | $933.25 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $295.12 | Professional | None | $144.54 | $213.80 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $204.17 | Professional | None | $120.23 | $120.23 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $7,413.10 Typical High $17,378.01 | Facility | None | $741.31 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $309.03 | Professional | None | $147.91 | $199.53 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $2,511.89 | Facility | None | $181.97 | $181.97 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $2,691.53 | Facility | None | $549.54 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $338.84 | Professional | None | $173.78 | $234.42 | $338.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $4,168.69 | Facility | None | $512.86 | $2,238.72 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $389.05 | Professional | None | $169.82 | $295.12 | $389.05 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $380.19 | Professional | None | $158.49 | $223.87 | $380.19 |
7 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 $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $72.44 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $29.51 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $109.65 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $31.62 Typical High $37.15 | Professional | 55 · Aftercare only | $21.88 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $147.91 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $102.33 | $147.91 | $173.78 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $147.91 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $102.33 | $147.91 | $239.88 |
Where Indiana sits
The same service costs 9.3 times more in Colorado 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.
Physician feeFacility fee
CO $5,912MT $637
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.