How much rates vary
Facilitymedian $11,749 · 10th to 90th $1,000 to $39,811Professionalmedian $3,090 · 10th to 90th $380 to $6,166
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 $457.09 Median $5,011.87 Typical High $8,128.31 | Facility | None | $457.09 | $5,011.87 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $1,380.38 Typical High $5,370.32 | Professional | None | $457.09 | $1,380.38 | $5,370.32 |
Ambetter Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,445.44 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $3,090.30 Typical High $4,897.79 | Professional | None | $346.74 | $3,090.30 | $4,897.79 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $13,489.63 | Facility | None | $426.58 | $426.58 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $9,120.11 Typical High $14,791.08 | Facility | None | $645.65 | $9,120.11 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $6,918.31 | Professional | None | $446.68 | $831.76 | $6,918.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,047.13 Median $12,302.69 Typical High $20,892.96 | Facility | None | $1,047.13 | $12,302.69 | $20,892.96 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $457.09 Median $1,047.13 Typical High $6,918.31 | Professional | None | $457.09 | $1,047.13 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $8,912.51 Typical High $16,595.87 | Facility | None | $1,621.81 | $8,912.51 | $16,595.87 |
United Setting Professional Modifier None Typical Low $467.74 Median $3,630.78 Typical High $8,317.64 | Professional | None | $467.74 | $3,630.78 | $8,317.64 |
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 $245.47 Median $2,041.74 Typical High $2,691.53 | Professional | 52 · Reduced service | $245.47 | $2,041.74 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $812.83 Typical High $1,071.52 | Professional | 53 · Discontinued | $97.72 | $812.83 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $3,090.30 Typical High $4,073.80 | Professional | 54 · Surgery only | $363.08 | $3,090.30 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $616.60 Typical High $812.83 | Professional | 55 · Aftercare only | $72.44 | $616.60 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $407.38 Typical High $537.03 | Professional | 56 · Pre-op care only | $48.98 | $407.38 | $537.03 |
Where Indiana sits
The same service costs 4.3 times more in Alabama than in Maine. 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
AL $20,420ME $4,758
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.