How much rates vary
Facilitymedian $2,138 · 10th to 90th $501 to $8,128Professionalmedian $437 · 10th to 90th $355 to $676
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 $467.74 Median $588.84 Typical High $5,248.07 | Facility | None | $467.74 | $588.84 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $446.68 | Professional | None | $363.08 | $407.38 | $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 $354.81 Median $436.52 Typical High $602.56 | Professional | None | $354.81 | $436.52 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $660.69 Typical High $912.01 | Professional | 50 · Both sides | $537.03 | $660.69 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $1,737.80 | Facility | None | $416.87 | $416.87 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,288.25 Typical High $2,187.76 | Facility | None | $549.54 | $1,288.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $891.25 | Professional | None | $407.38 | $478.63 | $891.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $1,862.09 Typical High $2,398.83 | Facility | None | $954.99 | $1,862.09 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $912.01 | Professional | None | $457.09 | $645.65 | $912.01 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $724.44 | Professional | None | $331.13 | $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 $181.97 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $181.97 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $74.13 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $275.42 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $309.03 |
Where Indiana sits
The same service costs 4.5 times more in Vermont than in Florida. 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
VT $4,521FL $1,007
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.