How much rates vary
Facilitymedian $1,230 · 10th to 90th $214 to $5,012Professionalmedian $513 · 10th to 90th $407 to $776
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 $537.03 Median $645.65 Typical High $5,011.87 | Facility | None | $537.03 | $645.65 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $549.54 | Professional | None | $426.58 | $467.74 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | None | $208.93 | $316.23 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,888.44 | Facility | None | $602.56 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $691.83 | Professional | None | $416.87 | $524.81 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $794.33 Typical High $1,071.52 | Professional | 50 · Both sides | $630.96 | $794.33 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $467.74 | Facility | None | $269.15 | $269.15 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $977.24 | Facility | None | $162.18 | $323.59 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $1,000.00 | Professional | None | $467.74 | $537.03 | $1,000.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $776.25 Typical High $1,621.81 | Facility | None | $229.09 | $776.25 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,023.29 | Professional | None | $501.19 | $707.95 | $1,023.29 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $831.76 | Professional | None | $380.19 | $478.63 | $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 $208.93 Median $234.42 Typical High $251.19 | Professional | 52 · Reduced service | $208.93 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $83.18 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $309.03 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $70.79 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $331.13 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $288.40 | $331.13 | $354.81 |
Where Indiana sits
The same service costs 4.7 times more in New York 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
NY $3,038FL $649
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.