How much rates vary
Facilitymedian $2,630 · 10th to 90th $617 to $8,318Professionalmedian $398 · 10th to 90th $275 to $631
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 $302.00 Median $5,011.87 Typical High $7,244.36 | Facility | None | $302.00 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $346.74 | Professional | None | $275.42 | $302.00 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $616.60 | Professional | None | $288.40 | $467.74 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $707.95 Typical High $954.99 | Professional | 50 · Both sides | $436.52 | $707.95 | $954.99 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $1,737.80 | Facility | None | $331.13 | $331.13 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,288.25 Typical High $2,187.76 | Facility | None | $549.54 | $1,288.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $3,548.13 | Professional | None | $302.00 | $363.08 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,819.70 Typical High $2,344.23 | Facility | None | $912.01 | $1,819.70 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $660.69 | Professional | None | $323.59 | $467.74 | $660.69 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $562.34 | Professional | None | $257.04 | $316.23 | $562.34 |
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 $138.04 Median $151.36 Typical High $165.96 | Professional | 52 · Reduced service | $138.04 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $54.95 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $208.93 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $33.11 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $229.09 |
Where Indiana sits
The same service costs 4.6 times more in Colorado 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
CO $4,822MT $1,050
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.