How much rates vary
Facilitymedian $2,344 · 10th to 90th $562 to $8,318Professionalmedian $575 · 10th to 90th $437 to $891
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 $467.74 Median $1,380.38 Typical High $7,244.36 | Facility | None | $467.74 | $1,380.38 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $588.84 | Professional | None | $457.09 | $512.86 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $831.76 | Professional | None | $436.52 | $660.69 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $1,000.00 Typical High $1,318.26 | Professional | 50 · Both sides | $660.69 | $1,000.00 | $1,318.26 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $1,737.80 | Facility | None | $512.86 | $512.86 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,096.48 Typical High $2,187.76 | Facility | None | $501.19 | $1,096.48 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,071.52 | Professional | None | $512.86 | $616.60 | $1,071.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,698.24 Typical High $2,344.23 | Facility | None | $912.01 | $1,698.24 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,096.48 | Professional | None | $537.03 | $776.25 | $1,096.48 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $954.99 | Professional | None | $426.58 | $537.03 | $954.99 |
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 $229.09 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $91.20 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $346.74 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $85.11 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $51.29 Typical High $56.23 | Professional | 56 · Pre-op care only | $45.71 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $389.05 |
Where Indiana sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.