How much rates vary
Facilitymedian $4,786 · 10th to 90th $977 to $15,136Professionalmedian $550 · 10th to 90th $468 to $912
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 $707.95 Typical High $14,125.38 | Facility | None | $562.34 | $707.95 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $812.83 | Professional | None | $489.78 | $537.03 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,288.25 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $724.44 | Professional | None | $446.68 | $549.54 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $3,235.94 | Facility | None | $588.84 | $588.84 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $2,454.71 Typical High $3,548.13 | Facility | None | $776.25 | $2,454.71 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $3,235.94 | Professional | None | $524.81 | $645.65 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,513.56 Median $3,388.44 Typical High $5,248.07 | Facility | None | $1,513.56 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,148.15 | Professional | None | $602.56 | $831.76 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $1,000.00 | Professional | None | $457.09 | $575.44 | $1,000.00 |
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 $245.47 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $245.47 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $97.72 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $371.54 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $407.38 |
Where Indiana sits
The same service costs 4.7 times more in Oklahoma 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
OK $8,820MT $1,888
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.