How much rates vary
Facilitymedian $2,630 · 10th to 90th $603 to $8,318Professionalmedian $407 · 10th to 90th $282 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 $309.03 Median $3,467.37 Typical High $7,244.36 | Facility | None | $309.03 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $602.56 | Professional | None | $309.03 | $457.09 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $676.08 Typical High $676.08 | Professional | None | $295.12 | $676.08 | $676.08 |
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 $281.84 Median $331.13 Typical High $467.74 | Professional | None | $281.84 | $331.13 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $501.19 Typical High $707.95 | Professional | 50 · Both sides | $426.58 | $501.19 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $1,479.11 | Facility | None | $338.84 | $338.84 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $2,089.30 | Facility | None | $549.54 | $1,096.48 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $933.25 | Professional | None | $338.84 | $512.86 | $933.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,584.89 Typical High $3,019.95 | Facility | None | $912.01 | $1,584.89 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $363.08 Median $645.65 Typical High $1,000.00 | Professional | None | $363.08 | $645.65 | $1,000.00 |
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 $281.84 Median $446.68 Typical High $776.25 | Professional | None | $281.84 | $446.68 | $776.25 |
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 $154.88 Median $208.93 Typical High $269.15 | Professional | 52 · Reduced service | $154.88 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $85.11 Typical High $107.15 | Professional | 53 · Discontinued | $61.66 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $316.23 Typical High $398.11 | Professional | 54 · Surgery only | $229.09 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $63.10 Typical High $79.43 | Professional | 55 · Aftercare only | $45.71 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $42.66 Typical High $53.70 | Professional | 56 · Pre-op care only | $30.90 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $295.12 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $213.80 | $295.12 | $371.54 |
Where Indiana sits
The same service costs 4.4 times more in Colorado than in Maryland. 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 $4,902MD $1,113
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.