How much rates vary
Facilitymedian $3,981 · 10th to 90th $776 to $14,125Professionalmedian $398 · 10th to 90th $295 to $661
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 $309.03 Median $3,467.37 Typical High $7,244.36 | Facility | None | $309.03 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $467.74 | Professional | None | $309.03 | $389.05 | $467.74 |
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 $275.42 Median $371.54 Typical High $524.81 | Professional | None | $275.42 | $371.54 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $3,235.94 | Facility | None | $338.84 | $338.84 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,187.76 Typical High $3,548.13 | Facility | None | $562.34 | $2,187.76 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $933.25 | Professional | None | $338.84 | $501.19 | $933.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,818.38 Typical High $5,248.07 | Facility | None | $912.01 | $2,818.38 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $363.08 Median $630.96 Typical High $933.25 | Professional | None | $363.08 | $630.96 | $933.25 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $724.44 | Professional | None | $288.40 | $426.58 | $724.44 |
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 $154.88 Median $194.98 Typical High $234.42 | Professional | 52 · Reduced service | $154.88 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $77.62 Typical High $95.50 | Professional | 53 · Discontinued | $61.66 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $295.12 Typical High $354.81 | Professional | 54 · Surgery only | $229.09 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $58.88 Typical High $70.79 | Professional | 55 · Aftercare only | $45.71 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.90 Typical High $46.77 | Professional | 56 · Pre-op care only | $30.90 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $275.42 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $213.80 | $275.42 | $331.13 |
Where Indiana sits
The same service costs 5.3 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 $6,378MT $1,213
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.