How much rates vary
Facilitymedian $3,388 · 10th to 90th $661 to $14,125Professionalmedian $479 · 10th to 90th $363 to $813
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 $389.05 Median $3,467.37 Typical High $7,244.36 | Facility | None | $389.05 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $588.84 | Professional | None | $389.05 | $467.74 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,413.10 Typical High $17,378.01 | Facility | None | $758.58 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $602.56 | Professional | None | $363.08 | $426.58 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $645.65 Typical High $912.01 | Professional | 50 · Both sides | $549.54 | $645.65 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $2,511.89 | Facility | None | $426.58 | $426.58 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $1,513.56 Typical High $2,630.27 | Facility | None | $467.74 | $1,513.56 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $954.99 | Professional | None | $426.58 | $602.56 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $4,168.69 | Facility | None | $912.01 | $2,089.30 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $1,096.48 | Professional | None | $446.68 | $776.25 | $1,096.48 |
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 $354.81 Median $512.86 Typical High $891.25 | Professional | None | $354.81 | $512.86 | $891.25 |
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 $194.98 Median $234.42 Typical High $295.12 | Professional | 52 · Reduced service | $194.98 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $93.33 Typical High $117.49 | Professional | 53 · Discontinued | $77.62 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $354.81 Typical High $436.52 | Professional | 54 · Surgery only | $295.12 | $354.81 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $70.79 Typical High $89.13 | Professional | 55 · Aftercare only | $58.88 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $46.77 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.90 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $331.13 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $275.42 | $331.13 | $407.38 |
Where Indiana sits
The same service costs 4.4 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 $6,491MT $1,489
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.