How much rates vary
Facilitymedian $4,365 · 10th to 90th $676 to $14,125Professionalmedian $646 · 10th to 90th $200 to $1,148
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 $208.93 Median $1,380.38 Typical High $7,244.36 | Facility | None | $208.93 | $1,380.38 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $707.95 Typical High $912.01 | Professional | None | $199.53 | $707.95 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $229.09 | Professional | None | $154.88 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,413.10 Typical High $17,378.01 | Facility | None | $758.58 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $676.08 Typical High $1,047.13 | Professional | None | $194.98 | $676.08 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $4,168.69 | Facility | None | $186.21 | $186.21 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $3,162.28 Typical High $4,466.84 | Facility | None | $562.34 | $3,162.28 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $630.96 Typical High $1,318.26 | Professional | None | $194.98 | $630.96 | $1,318.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $489.78 Median $3,630.78 Typical High $5,248.07 | Facility | None | $489.78 | $3,630.78 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $1,202.26 | Professional | None | $218.78 | $363.08 | $1,202.26 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $199.53 Median $616.60 Typical High $1,348.96 | Professional | None | $199.53 | $616.60 | $1,348.96 |
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 $104.71 Median $346.74 Typical High $446.68 | Professional | 52 · Reduced service | $104.71 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $141.25 Typical High $181.97 | Professional | 53 · Discontinued | $41.69 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $524.81 Typical High $676.08 | Professional | 54 · Surgery only | $158.49 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $104.71 Typical High $134.90 | Professional | 55 · Aftercare only | $31.62 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $70.79 Typical High $91.20 | Professional | 56 · Pre-op care only | $20.89 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $489.78 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $147.91 | $489.78 | $630.96 |
Where Indiana sits
The same service costs 5.1 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 $7,315MT $1,443
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.