How much rates vary
Facilitymedian $3,631 · 10th to 90th $724 to $8,318Professionalmedian $479 · 10th to 90th $380 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 $416.87 Median $5,011.87 Typical High $7,244.36 | Facility | None | $416.87 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $512.86 | Professional | None | $398.11 | $416.87 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $660.69 | Professional | None | $371.54 | $478.63 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $2,884.03 | Facility | None | $416.87 | $416.87 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,137.96 Typical High $3,235.94 | Facility | None | $549.54 | $2,137.96 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $831.76 | Professional | None | $416.87 | $549.54 | $831.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,122.02 Median $2,951.21 Typical High $4,677.35 | Facility | None | $1,122.02 | $2,951.21 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | None | $446.68 | $549.54 | $794.33 |
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 $398.11 Median $489.78 Typical High $741.31 | Professional | None | $398.11 | $489.78 | $741.31 |
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 $199.53 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $281.84 | $295.12 | $346.74 |
Where Indiana sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.