How much rates vary
Facilitymedian $3,631 · 10th to 90th $550 to $14,125Professionalmedian $389 · 10th to 90th $245 to $646
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 $302.00 Median $380.19 Typical High $5,623.41 | Facility | None | $302.00 | $380.19 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $316.23 | Professional | None | $245.47 | $251.19 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $7,413.10 Typical High $17,378.01 | Facility | None | $724.44 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $457.09 Typical High $616.60 | Professional | None | $234.42 | $457.09 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $691.83 Typical High $933.25 | Professional | 50 · Both sides | $354.81 | $691.83 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $147.91 Median $288.40 Typical High $389.05 | Professional | 62 · Two surgeons | $147.91 | $288.40 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $3,235.94 | Facility | None | $275.42 | $275.42 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $3,548.13 | Facility | None | $407.38 | $2,137.96 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $3,981.07 | Professional | None | $281.84 | $416.87 | $3,981.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $4,677.35 | Facility | None | $912.01 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $562.34 | Professional | None | $281.84 | $389.05 | $562.34 |
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 $223.87 Median $309.03 Typical High $524.81 | Professional | None | $223.87 | $309.03 | $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 $114.82 Median $125.89 Typical High $138.04 | Professional | 52 · Reduced service | $114.82 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $54.95 | Professional | 53 · Discontinued | $46.77 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $190.55 Typical High $204.17 | Professional | 54 · Surgery only | $173.78 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $40.74 | Professional | 55 · Aftercare only | $34.67 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.12 Typical High $27.54 | Professional | 56 · Pre-op care only | $22.91 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $177.83 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $162.18 | $177.83 | $190.55 |
Where Indiana sits
The same service costs 7.3 times more in Colorado 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
CO $6,269MT $863
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.