How much rates vary
Facilitymedian $2,399 · 10th to 90th $490 to $8,318Professionalmedian $224 · 10th to 90th $126 to $427
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 $125.89 Median $3,467.37 Typical High $5,623.41 | Facility | None | $125.89 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $288.40 Typical High $389.05 | Professional | None | $125.89 | $288.40 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $269.15 Typical High $389.05 | Professional | None | $141.25 | $269.15 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $1,778.28 | Facility | None | $131.83 | $131.83 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $1,071.52 Typical High $1,905.46 | Facility | None | $208.93 | $1,071.52 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $549.54 | Professional | None | $134.90 | $199.53 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $346.74 Median $1,862.09 Typical High $2,754.23 | Facility | None | $346.74 | $1,862.09 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $630.96 | Professional | None | $151.36 | $251.19 | $630.96 |
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 $123.03 Median $190.55 Typical High $457.09 | Professional | None | $123.03 | $190.55 | $457.09 |
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 $63.10 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $63.10 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $25.12 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $257.04 Typical High $288.40 | Professional | 54 · Surgery only | $95.50 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $51.29 Typical High $57.54 | Professional | 55 · Aftercare only | $19.05 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $12.59 | $34.67 | $38.90 |
Where Indiana sits
The same service costs 5.7 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 $4,090MT $722
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.