How much rates vary
Facilitymedian $2,630 · 10th to 90th $562 to $8,318Professionalmedian $251 · 10th to 90th $174 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 $181.97 Median $537.03 Typical High $5,623.41 | Facility | None | $181.97 | $537.03 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $331.13 | Professional | None | $165.96 | $263.03 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $295.12 | Professional | None | $162.18 | $218.78 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $331.13 Typical High $457.09 | Professional | 50 · Both sides | $245.47 | $331.13 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $1,737.80 | Facility | None | $186.21 | $186.21 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,288.25 Typical High $1,905.46 | Facility | None | $407.38 | $1,288.25 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $691.83 | Professional | None | $194.98 | $354.81 | $691.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $891.25 Median $1,548.82 Typical High $2,344.23 | Facility | None | $891.25 | $1,548.82 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $616.60 | Professional | None | $208.93 | $380.19 | $616.60 |
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 $162.18 Median $302.00 Typical High $524.81 | Professional | None | $162.18 | $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 $87.10 Median $131.83 Typical High $158.49 | Professional | 52 · Reduced service | $87.10 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $52.48 Typical High $64.57 | Professional | 53 · Discontinued | $34.67 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $194.98 Typical High $239.88 | Professional | 54 · Surgery only | $128.82 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.90 Typical High $47.86 | Professional | 55 · Aftercare only | $26.30 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $17.38 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $181.97 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $120.23 | $181.97 | $223.87 |
Where Indiana sits
The same service costs 6.4 times more in Oklahoma than in North Dakota. 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 $5,125ND $804
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.