How much rates vary
Facilitymedian $2,692 · 10th to 90th $513 to $8,318Professionalmedian $275 · 10th to 90th $182 to $417
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 $181.97 Median $5,011.87 Typical High $7,244.36 | Facility | None | $181.97 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $371.54 | Professional | None | $181.97 | $275.42 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $389.05 | Professional | None | $190.55 | $263.03 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $2,041.74 | Facility | None | $229.09 | $229.09 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $2,398.83 | Facility | None | $309.03 | $1,380.38 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $416.87 | Professional | None | $208.93 | $295.12 | $416.87 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $575.44 Median $1,819.70 Typical High $2,630.27 | Facility | None | $575.44 | $1,819.70 | $2,630.27 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $446.68 | Professional | None | $281.84 | $288.40 | $446.68 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $501.19 | Professional | None | $204.17 | $309.03 | $501.19 |
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 $91.20 Median $134.90 Typical High $162.18 | Professional | 52 · Reduced service | $91.20 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $37.15 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $204.17 Typical High $245.47 | Professional | 54 · Surgery only | $138.04 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $27.54 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $18.20 | $26.92 | $32.36 |
Where Indiana sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.