How much rates vary
Facilitymedian $3,236 · 10th to 90th $631 to $8,318Professionalmedian $513 · 10th to 90th $347 to $776
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 $398.11 Median $3,467.37 Typical High $7,244.36 | Facility | None | $398.11 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $575.44 | Professional | None | $398.11 | $524.81 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $676.08 | Professional | None | $346.74 | $457.09 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $2,884.03 | Facility | None | $407.38 | $407.38 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $1,778.28 Typical High $3,162.28 | Facility | None | $467.74 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $724.44 | Professional | None | $416.87 | $562.34 | $724.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,023.29 Median $2,454.71 Typical High $4,677.35 | Facility | None | $1,023.29 | $2,454.71 | $4,677.35 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $954.99 | Professional | None | $489.78 | $707.95 | $954.99 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $977.24 | Professional | None | $354.81 | $512.86 | $977.24 |
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 $199.53 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $199.53 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $79.43 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $302.00 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $60.26 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $39.81 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $281.84 | $363.08 | $398.11 |
Where Indiana sits
The same service costs 4.6 times more in Oklahoma 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
OK $6,614MT $1,440
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.