How much rates vary
Facilitymedian $28,184 · 10th to 90th $1,202 to $61,660Professionalmedian $1,202 · 10th to 90th $794 to $1,778
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 $954.99 Median $1,380.38 Typical High $36,307.81 | Facility | None | $954.99 | $1,380.38 | $36,307.81 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,380.38 | Professional | None | $912.01 | $1,023.29 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $933.25 | Professional | None | $891.25 | $891.25 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $38,904.51 Typical High $77,624.71 | Facility | None | $2,290.87 | $38,904.51 | $77,624.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,348.96 Typical High $1,819.70 | Professional | None | $724.44 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $851.14 Typical High $1,148.15 | Professional | 62 · Two surgeons | $457.09 | $851.14 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $51,286.14 | Facility | None | $912.01 | $912.01 | $51,286.14 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $37,153.52 Typical High $50,118.72 | Facility | None | $630.96 | $37,153.52 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,905.46 | Professional | None | $912.01 | $1,202.26 | $1,905.46 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $46,773.51 Typical High $64,565.42 | Facility | None | $2,089.30 | $46,773.51 | $64,565.42 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,513.56 | Professional | None | $891.25 | $1,122.02 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $15,848.93 Typical High $57,543.99 | Facility | None | $1,548.82 | $15,848.93 | $57,543.99 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,737.80 | Professional | None | $870.96 | $1,230.27 | $1,737.80 |
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 $457.09 Median $512.86 Typical High $575.44 | Professional | 52 · Reduced service | $457.09 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $204.17 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $776.25 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $102.33 Typical High $114.82 | Professional | 56 · Pre-op care only | $91.20 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $724.44 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $724.44 | $794.33 |
Where Indiana sits
The same service costs 19.9 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 $53,750MT $2,699
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.