How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $19,498Professionalmedian $1,202 · 10th to 90th $933 to $1,622
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 $1,096.48 Median $5,011.87 Typical High $14,125.38 | Facility | None | $1,096.48 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,096.48 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $11,481.54 Typical High $23,442.29 | Facility | None | $1,412.54 | $11,481.54 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,380.38 | Professional | None | $851.14 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,548.82 Typical High $2,137.96 | Professional | 50 · Both sides | $1,258.93 | $1,548.82 | $2,137.96 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $6,025.60 | Facility | None | $1,096.48 | $1,096.48 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,467.37 Typical High $6,456.54 | Facility | None | $676.08 | $3,467.37 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,318.26 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $5,495.41 Typical High $8,511.38 | Facility | None | $954.99 | $5,495.41 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $2,041.74 | Professional | None | $870.96 | $1,380.38 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,230.27 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,258.93 | $1,905.46 |
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 $524.81 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $524.81 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $794.33 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $870.96 |
Where Indiana sits
The same service costs 3.4 times more in Alaska 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
AK $11,546MT $3,436
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.