How much rates vary
Facilitymedian $2,042 · 10th to 90th $617 to $8,318Professionalmedian $589 · 10th to 90th $457 to $891
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 $562.34 Median $741.31 Typical High $5,011.87 | Facility | None | $562.34 | $741.31 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $812.83 | Professional | None | $478.63 | $512.86 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $524.81 Typical High $602.56 | Professional | None | $281.84 | $524.81 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $776.25 | Professional | None | $478.63 | $588.84 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $891.25 Typical High $1,202.26 | Professional | 50 · Both sides | $741.31 | $891.25 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $1,737.80 | Facility | None | $524.81 | $524.81 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,348.96 Typical High $2,454.71 | Facility | None | $630.96 | $1,348.96 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,174.90 | Professional | None | $524.81 | $630.96 | $1,174.90 |
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 $588.84 Median $812.83 Typical High $1,148.15 | Professional | None | $588.84 | $812.83 | $1,148.15 |
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 $436.52 Median $575.44 Typical High $954.99 | Professional | None | $436.52 | $575.44 | $954.99 |
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 $229.09 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $91.20 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $346.74 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $51.29 Typical High $56.23 | Professional | 56 · Pre-op care only | $45.71 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $389.05 |
Where Indiana sits
The same service costs 4.0 times more in Colorado 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
CO $4,440FL $1,118
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.