How much rates vary
Facilitymedian $20,893 · 10th to 90th $1,995 to $56,234Professionalmedian $2,512 · 10th to 90th $457 to $8,511
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 $575.44 Median $5,011.87 Typical High $17,782.79 | Facility | None | $575.44 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $1,621.81 Typical High $6,309.57 | Professional | None | $549.54 | $1,621.81 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $36,307.81 Typical High $70,794.58 | Facility | None | $2,238.72 | $36,307.81 | $70,794.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $4,073.80 Typical High $7,585.78 | Professional | None | $407.38 | $4,073.80 | $7,585.78 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $24,547.09 | Facility | None | $512.86 | $512.86 | $24,547.09 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $19,054.61 Typical High $26,915.35 | Facility | None | $645.65 | $19,054.61 | $26,915.35 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $8,912.51 | Professional | None | $537.03 | $1,000.00 | $8,912.51 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,258.93 Median $19,054.61 Typical High $30,902.95 | Facility | None | $1,258.93 | $19,054.61 | $30,902.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $537.03 Median $1,258.93 Typical High $8,709.64 | Professional | None | $537.03 | $1,258.93 | $8,709.64 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $12,302.69 Typical High $43,651.58 | Facility | None | $2,238.72 | $12,302.69 | $43,651.58 |
United Setting Professional Modifier None Typical Low $537.03 Median $5,128.61 Typical High $10,964.78 | Professional | None | $537.03 | $5,128.61 | $10,964.78 |
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 $275.42 Median $2,398.83 Typical High $3,162.28 | Professional | 52 · Reduced service | $275.42 | $2,398.83 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $954.99 Typical High $1,258.93 | Professional | 53 · Discontinued | $112.20 | $954.99 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $3,548.13 Typical High $4,677.35 | Professional | 54 · Surgery only | $416.87 | $3,548.13 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $724.44 Typical High $933.25 | Professional | 55 · Aftercare only | $83.18 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $478.63 Typical High $630.96 | Professional | 56 · Pre-op care only | $54.95 | $478.63 | $630.96 |
Where Indiana sits
The same service costs 6.1 times more in Alaska than in Vermont. 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 $33,081VT $5,424
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.