How much rates vary
Facilitymedian $2,455 · 10th to 90th $631 to $8,318Professionalmedian $912 · 10th to 90th $676 to $1,349
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 $707.95 Median $5,011.87 Typical High $7,244.36 | Facility | None | $707.95 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $851.14 | Professional | None | $645.65 | $707.95 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,230.27 | Professional | None | $691.83 | $977.24 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,445.44 Typical High $1,905.46 | Professional | 50 · Both sides | $1,023.29 | $1,445.44 | $1,905.46 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $1,737.80 | Facility | None | $776.25 | $776.25 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,202.26 Typical High $2,187.76 | Facility | None | $562.34 | $1,202.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $5,248.07 | Professional | None | $776.25 | $977.24 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,949.84 Typical High $2,344.23 | Facility | None | $912.01 | $1,949.84 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,513.56 | Professional | None | $776.25 | $1,096.48 | $1,513.56 |
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 $616.60 Median $831.76 Typical High $1,348.96 | Professional | None | $616.60 | $831.76 | $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 $323.59 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $323.59 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $64.57 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $549.54 |
Where Indiana sits
The same service costs 3.6 times more in Alaska 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
AK $5,545AL $1,558
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.