How much rates vary
Facilitymedian $2,042 · 10th to 90th $174 to $5,129Professionalmedian $288 · 10th to 90th $234 to $490
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 $263.03 Median $1,380.38 Typical High $5,011.87 | Facility | None | $263.03 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $346.74 | Professional | None | $263.03 | $288.40 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $363.08 | Professional | None | $234.42 | $275.42 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $288.40 | Facility | None | $269.15 | $269.15 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $208.93 Typical High $354.81 | Facility | None | $66.07 | $208.93 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $630.96 | Professional | None | $269.15 | $346.74 | $630.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $776.25 Typical High $1,122.02 | Facility | None | $229.09 | $776.25 | $1,122.02 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $676.08 | Professional | None | $316.23 | $446.68 | $676.08 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $524.81 | Professional | None | $234.42 | $302.00 | $524.81 |
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 $131.83 Median $141.25 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $52.48 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $194.98 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $229.09 |
Where Indiana sits
The same service costs 6.7 times more in New York than in Florida. 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
NY $2,828FL $419
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.