How much rates vary
Facilitymedian $4,169 · 10th to 90th $933 to $14,125Professionalmedian $724 · 10th to 90th $490 to $1,122
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 $5,011.87 Typical High $11,220.18 | Facility | None | $524.81 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $588.84 | Professional | None | $478.63 | $524.81 | $588.84 |
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 $489.78 Median $758.58 Typical High $1,000.00 | Professional | None | $489.78 | $758.58 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $3,235.94 | Facility | None | $575.44 | $575.44 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,344.23 Typical High $3,548.13 | Facility | None | $630.96 | $2,344.23 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $5,495.41 | Professional | None | $575.44 | $776.25 | $5,495.41 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,174.90 | Professional | None | $524.81 | $794.33 | $1,174.90 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $1,071.52 | Professional | None | $446.68 | $616.60 | $1,071.52 |
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 $239.88 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $239.88 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $95.50 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $436.52 | Professional | 54 · Surgery only | $363.08 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $407.38 |
Where Indiana sits
The same service costs 4.1 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 $7,594MT $1,845
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.