How much rates vary
Facilitymedian $1,698 · 10th to 90th $214 to $5,129Professionalmedian $288 · 10th to 90th $224 to $479
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 $269.15 Median $2,344.23 Typical High $5,623.41 | Facility | None | $269.15 | $2,344.23 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $363.08 | Professional | None | $223.87 | $295.12 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,888.44 | Facility | None | $602.56 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $346.74 | Professional | None | $223.87 | $263.03 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $398.11 Typical High $537.03 | Professional | 50 · Both sides | $338.84 | $398.11 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $295.12 | Facility | None | $269.15 | $269.15 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $269.15 Typical High $794.33 | Facility | None | $162.18 | $269.15 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $616.60 | Professional | None | $275.42 | $323.59 | $616.60 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $776.25 Typical High $1,047.13 | Facility | None | $229.09 | $776.25 | $1,047.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $645.65 | Professional | None | $316.23 | $446.68 | $645.65 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $512.86 | Professional | None | $229.09 | $295.12 | $512.86 |
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 $131.83 Median $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $63.10 | Professional | 53 · Discontinued | $52.48 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $218.78 Typical High $239.88 | Professional | 54 · Surgery only | $194.98 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $47.86 | Professional | 55 · Aftercare only | $38.90 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $204.17 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $181.97 | $204.17 | $223.87 |
Where Indiana sits
The same service costs 6.5 times more in Connecticut than in Maryland. 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
CT $3,149MD $483
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.