How much rates vary
Facilitymedian $3,467 · 10th to 90th $617 to $14,125Professionalmedian $407 · 10th to 90th $269 to $631
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 $275.42 Median $1,380.38 Typical High $7,244.36 | Facility | None | $275.42 | $1,380.38 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $512.86 | Professional | None | $275.42 | $426.58 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,413.10 Typical High $17,378.01 | Facility | None | $758.58 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $588.84 | Professional | None | $269.15 | $389.05 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $575.44 Typical High $870.96 | Professional | 50 · Both sides | $398.11 | $575.44 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $2,511.89 | Facility | None | $338.84 | $338.84 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,513.56 Typical High $2,630.27 | Facility | None | $416.87 | $1,513.56 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $630.96 | Professional | None | $275.42 | $457.09 | $630.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $4,168.69 | Facility | None | $912.01 | $2,238.72 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $316.23 Median $575.44 Typical High $741.31 | Professional | None | $316.23 | $575.44 | $741.31 |
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 $275.42 Median $426.58 Typical High $724.44 | Professional | None | $275.42 | $426.58 | $724.44 |
6 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 $138.04 Median $204.17 Typical High $245.47 | Professional | 52 · Reduced service | $138.04 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $81.28 Typical High $100.00 | Professional | 53 · Discontinued | $54.95 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $309.03 Typical High $371.54 | Professional | 54 · Surgery only | $204.17 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $40.74 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $27.54 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $288.40 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $190.55 | $288.40 | $346.74 |
Where Indiana sits
The same service costs 5.3 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 $6,438MT $1,226
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.