How much rates vary
Facilitymedian $3,802 · 10th to 90th $891 to $14,125Professionalmedian $427 · 10th to 90th $295 to $724
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 $380.19 Median $3,467.37 Typical High $11,220.18 | Facility | None | $380.19 | $3,467.37 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $575.44 | Professional | None | $338.84 | $426.58 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $416.87 | Professional | None | $251.19 | $295.12 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $3,235.94 | Facility | None | $407.38 | $407.38 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,995.26 Typical High $3,467.37 | Facility | None | $436.52 | $1,995.26 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $933.25 | Professional | None | $407.38 | $537.03 | $933.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $5,248.07 | Facility | None | $1,096.48 | $2,818.38 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $1,071.52 | Professional | None | $446.68 | $758.58 | $1,071.52 |
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 $331.13 Median $501.19 Typical High $870.96 | Professional | None | $331.13 | $501.19 | $870.96 |
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 $190.55 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $190.55 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $75.86 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $288.40 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $316.23 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $269.15 | $316.23 | $389.05 |
Where Indiana sits
The same service costs 5.8 times more in Alabama 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
AL $8,423MT $1,458
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.