How much rates vary
Facilitymedian $3,236 · 10th to 90th $617 to $14,125Professionalmedian $479 · 10th to 90th $372 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 $478.63 Median $5,011.87 Typical High $7,244.36 | Facility | None | $478.63 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $524.81 | Professional | None | $426.58 | $478.63 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $7,413.10 Typical High $17,378.01 | Facility | None | $741.31 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $602.56 | Professional | None | $371.54 | $436.52 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $3,235.94 | Facility | None | $512.86 | $512.86 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,995.26 Typical High $3,467.37 | Facility | None | $512.86 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $3,235.94 | Professional | None | $478.63 | $602.56 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,398.83 Typical High $4,677.35 | Facility | None | $912.01 | $2,398.83 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $436.52 Median $741.31 Typical High $1,023.29 | Professional | None | $436.52 | $741.31 | $1,023.29 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $851.14 | Professional | None | $389.05 | $489.78 | $851.14 |
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 $213.80 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $213.80 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $85.11 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $323.59 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $42.66 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $302.00 | $338.84 | $363.08 |
Where Indiana sits
The same service costs 5.4 times more in Colorado than in Alabama. 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 $6,331AL $1,183
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.