How much rates vary
Facilitymedian $4,169 · 10th to 90th $589 to $14,125Professionalmedian $501 · 10th to 90th $195 to $1,072
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 $5,011.87 Typical High $14,125.38 | Facility | None | $208.93 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $549.54 Typical High $691.83 | Professional | None | $199.53 | $549.54 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $524.81 Typical High $1,148.15 | Professional | None | $181.97 | $524.81 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $870.96 | Facility | None | $181.97 | $181.97 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $645.65 Typical High $1,479.11 | Facility | None | $295.12 | $645.65 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $489.78 Typical High $1,258.93 | Professional | None | $204.17 | $489.78 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $478.63 Median $1,148.15 Typical High $4,570.88 | Facility | None | $478.63 | $1,148.15 | $4,570.88 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $912.01 | Professional | None | $213.80 | $363.08 | $912.01 |
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 $194.98 Median $489.78 Typical High $1,096.48 | Professional | None | $194.98 | $489.78 | $1,096.48 |
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 $97.72 Median $275.42 Typical High $346.74 | Professional | 52 · Reduced service | $97.72 | $275.42 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $109.65 Typical High $138.04 | Professional | 53 · Discontinued | $39.81 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $407.38 Typical High $512.86 | Professional | 54 · Surgery only | $147.91 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $81.28 Typical High $102.33 | Professional | 55 · Aftercare only | $29.51 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $54.95 Typical High $69.18 | Professional | 56 · Pre-op care only | $19.95 | $54.95 | $69.18 |
Where Indiana sits
The same service costs 6.9 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 $7,377MT $1,063
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.