How much rates vary
Facilitymedian $2,042 · 10th to 90th $407 to $8,318Professionalmedian $427 · 10th to 90th $339 to $692
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 $398.11 Median $3,467.37 Typical High $5,623.41 | Facility | None | $398.11 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | None | $389.05 | $436.52 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $537.03 | Professional | None | $331.13 | $389.05 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $588.84 Typical High $831.76 | Professional | 50 · Both sides | $501.19 | $588.84 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $1,737.80 | Facility | None | $436.52 | $436.52 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,047.13 Typical High $1,819.70 | Facility | None | $407.38 | $1,047.13 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $912.01 | Professional | None | $389.05 | $478.63 | $912.01 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,548.82 Typical High $2,344.23 | Facility | None | $912.01 | $1,548.82 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $977.24 | Professional | None | $467.74 | $676.08 | $977.24 |
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 $338.84 Median $436.52 Typical High $758.58 | Professional | None | $338.84 | $436.52 | $758.58 |
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 $194.98 Median $218.78 Typical High $239.88 | Professional | 52 · Reduced service | $194.98 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $77.62 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $295.12 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.90 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $331.13 |
Where Indiana sits
The same service costs 5.3 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 $4,377FL $831
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.