How much rates vary
Facilitymedian $3,981 · 10th to 90th $977 to $14,125Professionalmedian $389 · 10th to 90th $288 to $724
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 $316.23 Median $5,011.87 Typical High $11,220.18 | Facility | None | $316.23 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $512.86 | Professional | None | $309.03 | $316.23 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $524.81 | Professional | None | $281.84 | $389.05 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $2,511.89 | Facility | None | $346.74 | $346.74 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $2,691.53 | Facility | None | $630.96 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $3,467.37 | Professional | None | $354.81 | $630.96 | $3,467.37 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,570.40 Typical High $4,168.69 | Facility | None | $912.01 | $2,570.40 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $691.83 | Professional | None | $331.13 | $478.63 | $691.83 |
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 $288.40 Median $512.86 Typical High $758.58 | Professional | None | $288.40 | $512.86 | $758.58 |
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 $144.54 Median $158.49 Typical High $173.78 | Professional | 52 · Reduced service | $144.54 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $70.79 | Professional | 53 · Discontinued | $58.88 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $218.78 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $47.86 Typical High $52.48 | Professional | 55 · Aftercare only | $43.65 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $34.67 |
Where Indiana sits
The same service costs 6.1 times more in Oklahoma 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
OK $6,602MT $1,074
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.