How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,047 to $14,791Professionalmedian $501 · 10th to 90th $407 to $794
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 $446.68 Median $676.08 Typical High $17,782.79 | Facility | None | $446.68 | $676.08 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $741.31 | Professional | None | $407.38 | $446.68 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,659.59 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $676.08 | Professional | None | $416.87 | $501.19 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $3,235.94 | Facility | None | $489.78 | $489.78 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $2,511.89 Typical High $4,677.35 | Facility | None | $1,230.27 | $2,511.89 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $3,311.31 | Professional | None | $467.74 | $588.84 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $4,677.35 | Facility | None | $1,258.93 | $3,235.94 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $954.99 | Professional | None | $501.19 | $691.83 | $954.99 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $831.76 | Professional | None | $380.19 | $489.78 | $831.76 |
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 $204.17 Median $223.87 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $67.61 Typical High $72.44 | Professional | 55 · Aftercare only | $60.26 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $316.23 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $281.84 | $316.23 | $338.84 |
Where Indiana sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.