How much rates vary
Facilitymedian $4,074 · 10th to 90th $912 to $14,125Professionalmedian $871 · 10th to 90th $692 to $1,318
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 $741.31 Median $5,011.87 Typical High $11,220.18 | Facility | None | $741.31 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $831.76 | Professional | None | $660.69 | $741.31 | $831.76 |
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 $707.95 Median $870.96 Typical High $1,148.15 | Professional | None | $707.95 | $870.96 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $3,235.94 | Facility | None | $794.33 | $794.33 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $3,467.37 | Facility | None | $645.65 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $5,370.32 | Professional | None | $776.25 | $977.24 | $5,370.32 |
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 $691.83 Median $1,174.90 Typical High $1,621.81 | Professional | None | $691.83 | $1,174.90 | $1,621.81 |
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 $616.60 Median $794.33 Typical High $1,348.96 | Professional | None | $616.60 | $794.33 | $1,348.96 |
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 $331.13 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $151.36 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $562.34 |
Where Indiana sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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
WI $7,619HI $2,493
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.