How much rates vary
Facilitymedian $3,715 · 10th to 90th $603 to $14,125Professionalmedian $331 · 10th to 90th $219 to $513
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 $263.03 Median $323.59 Typical High $7,244.36 | Facility | None | $263.03 | $323.59 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $302.00 | Professional | None | $245.47 | $245.47 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $7,413.10 Typical High $17,378.01 | Facility | None | $851.14 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $389.05 Typical High $512.86 | Professional | None | $199.53 | $389.05 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $3,311.31 | Facility | None | $251.19 | $251.19 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,187.76 Typical High $3,630.78 | Facility | None | $549.54 | $2,187.76 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $524.81 | Professional | None | $257.04 | $323.59 | $524.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $660.69 Median $3,467.37 Typical High $5,370.32 | Facility | None | $660.69 | $3,467.37 | $5,370.32 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $436.52 | Professional | None | $245.47 | $316.23 | $436.52 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $436.52 | Professional | None | $234.42 | $302.00 | $436.52 |
5 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 $120.23 Median $123.03 Typical High $141.25 | Professional | 52 · Reduced service | $120.23 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $56.23 | Professional | 53 · Discontinued | $48.98 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $181.97 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $28.18 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $28.18 |
Where Indiana sits
The same service costs 8.5 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 $6,252MT $735
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.