How much rates vary
Facilitymedian $7,413 · 10th to 90th $851 to $28,840Professionalmedian $525 · 10th to 90th $417 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 $537.03 Median $707.95 Typical High $9,120.11 | Facility | None | $537.03 | $707.95 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $707.95 | Professional | None | $436.52 | $524.81 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $758.58 | Professional | None | $501.19 | $645.65 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $14,454.40 Typical High $33,113.11 | Facility | None | $1,479.11 | $14,454.40 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $676.08 | Professional | None | $416.87 | $489.78 | $676.08 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $309.03 Typical High $436.52 | Professional | 62 · Two surgeons | $263.03 | $309.03 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $9,332.54 | Facility | None | $575.44 | $575.44 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $6,165.95 Typical High $10,232.93 | Facility | None | $776.25 | $6,165.95 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $3,311.31 | Professional | None | $537.03 | $645.65 | $3,311.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,513.56 Median $9,772.37 Typical High $12,022.64 | Facility | None | $1,513.56 | $9,772.37 | $12,022.64 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,122.02 | Professional | None | $549.54 | $812.83 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $977.24 | Professional | None | $446.68 | $562.34 | $977.24 |
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 $239.88 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $371.54 | $389.05 |
Where Indiana sits
The same service costs 7.5 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 $13,659MT $1,825
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.