How much rates vary
Facilitymedian $2,089 · 10th to 90th $708 to $8,128Professionalmedian $316 · 10th to 90th $174 to $468
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 $186.21 Median $5,011.87 Typical High $16,595.87 | Facility | None | $186.21 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | None | $186.21 | $186.21 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $8,912.51 | Facility | None | $851.14 | $2,754.23 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $346.74 Typical High $457.09 | Professional | None | $158.49 | $346.74 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $1,819.70 | Facility | None | $204.17 | $204.17 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $2,398.83 | Facility | None | $645.65 | $1,348.96 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $575.44 | Professional | None | $208.93 | $331.13 | $575.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $501.19 Median $1,905.46 Typical High $3,019.95 | Facility | None | $501.19 | $1,905.46 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $380.19 | Professional | None | $194.98 | $257.04 | $380.19 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $436.52 | Professional | None | $190.55 | $316.23 | $436.52 |
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 $93.33 Median $93.33 Typical High $104.71 | Professional | 52 · Reduced service | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $37.15 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $138.04 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $20.89 |
Where Indiana sits
The same service costs 7.6 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 $4,681MT $618
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.