How much rates vary
Facilitymedian $3,981 · 10th to 90th $933 to $14,125Professionalmedian $437 · 10th to 90th $324 to $741
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 $331.13 Median $3,467.37 Typical High $11,220.18 | Facility | None | $331.13 | $3,467.37 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $562.34 | Professional | None | $309.03 | $416.87 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,047.13 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $562.34 | Professional | None | $323.59 | $398.11 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $602.56 Typical High $851.14 | Professional | 50 · Both sides | $478.63 | $602.56 | $851.14 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $3,235.94 | Facility | None | $371.54 | $371.54 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,344.23 Typical High $3,548.13 | Facility | None | $630.96 | $2,344.23 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $1,023.29 | Professional | None | $371.54 | $575.44 | $1,023.29 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $4,677.35 | Facility | None | $912.01 | $2,290.87 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $398.11 Median $691.83 Typical High $1,023.29 | Professional | None | $398.11 | $691.83 | $1,023.29 |
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 $316.23 Median $489.78 Typical High $831.76 | Professional | None | $316.23 | $489.78 | $831.76 |
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 $165.96 Median $218.78 Typical High $263.03 | Professional | 52 · Reduced service | $165.96 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $87.10 Typical High $104.71 | Professional | 53 · Discontinued | $67.61 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $323.59 Typical High $398.11 | Professional | 54 · Surgery only | $251.19 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $50.12 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $43.65 Typical High $52.48 | Professional | 56 · Pre-op care only | $33.11 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $302.00 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $234.42 | $302.00 | $371.54 |
Where Indiana sits
The same service costs 4.7 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 $6,438MT $1,383
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.