How much rates vary
Facilitymedian $3,715 · 10th to 90th $794 to $14,125Professionalmedian $550 · 10th to 90th $407 to $813
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 $524.81 Median $562.34 Typical High $11,220.18 | Facility | None | $524.81 | $562.34 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $562.34 | Professional | None | $407.38 | $446.68 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $724.44 | Professional | None | $407.38 | $549.54 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $3,235.94 | Facility | None | $478.63 | $478.63 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,995.26 Typical High $3,467.37 | Facility | None | $537.03 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $3,388.44 | Professional | None | $467.74 | $588.84 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,230.27 Median $3,388.44 Typical High $5,248.07 | Facility | None | $1,230.27 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $954.99 | Professional | None | $446.68 | $676.08 | $954.99 |
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 $380.19 Median $501.19 Typical High $831.76 | Professional | None | $380.19 | $501.19 | $831.76 |
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 $199.53 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $67.61 Typical High $72.44 | Professional | 55 · Aftercare only | $60.26 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $281.84 | $309.03 | $338.84 |
Where Indiana sits
The same service costs 4.6 times more in Alabama 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
AL $7,006MT $1,517
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.