How much rates vary
Facilitymedian $4,074 · 10th to 90th $832 to $13,490Professionalmedian $776 · 10th to 90th $575 to $1,202
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 $645.65 Median $831.76 Typical High $9,549.93 | Facility | None | $645.65 | $831.76 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $870.96 | Professional | None | $575.44 | $645.65 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $831.76 Typical High $891.25 | Professional | None | $380.19 | $831.76 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $7,413.10 Typical High $15,135.61 | Facility | None | $1,148.15 | $7,413.10 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,148.15 | Professional | None | $588.84 | $870.96 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,318.26 Typical High $1,737.80 | Professional | 50 · Both sides | $891.25 | $1,318.26 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $3,235.94 | Facility | None | $707.95 | $707.95 | $3,235.94 |
CareSource Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $891.25 | Professional | None | $630.96 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,344.23 Typical High $3,548.13 | Facility | None | $630.96 | $2,344.23 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $4,265.80 | Professional | None | $691.83 | $831.76 | $4,265.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,778.28 Median $3,388.44 Typical High $5,248.07 | Facility | None | $1,778.28 | $3,388.44 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,348.96 | Professional | None | $707.95 | $977.24 | $1,348.96 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,466.84 Typical High $9,120.11 | Facility | None | $870.96 | $4,466.84 | $9,120.11 |
United Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,230.27 | Professional | None | $562.34 | $741.31 | $1,230.27 |
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 $295.12 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $295.12 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $117.49 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $436.52 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $489.78 |
Where Indiana sits
The same service costs 3.6 times more in Wisconsin 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
WI $7,904MT $2,218
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.