How much rates vary
Facilitymedian $2,951 · 10th to 90th $631 to $8,318Professionalmedian $776 · 10th to 90th $661 to $1,698
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 $724.44 Median $954.99 Typical High $7,244.36 | Facility | None | $724.44 | $954.99 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $1,122.02 | Professional | None | $660.69 | $676.08 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,698.24 | Professional | None | $660.69 | $776.25 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $2,041.74 | Facility | None | $812.83 | $812.83 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,511.89 Typical High $4,168.69 | Facility | None | $549.54 | $2,511.89 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,258.93 | Professional | None | $691.83 | $794.33 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,023.29 Median $2,187.76 Typical High $4,897.79 | Facility | None | $1,023.29 | $2,187.76 | $4,897.79 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $588.84 Median $1,000.00 Typical High $1,380.38 | Professional | None | $588.84 | $1,000.00 | $1,380.38 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,258.93 | Professional | None | $616.60 | $812.83 | $1,258.93 |
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 $331.13 Median $331.13 Typical High $398.11 | Professional | 52 · Reduced service | $331.13 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $562.34 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Georgia. 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
AK $7,038GA $2,000
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.