How much rates vary
Facilitymedian $5,495 · 10th to 90th $891 to $19,498Professionalmedian $447 · 10th to 90th $372 to $676
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 $467.74 Median $524.81 Typical High $11,220.18 | Facility | None | $467.74 | $524.81 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $630.96 | Professional | None | $446.68 | $446.68 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $478.63 | Professional | None | $346.74 | $380.19 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $11,220.18 Typical High $23,442.29 | Facility | None | $1,380.38 | $11,220.18 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $524.81 | Professional | None | $371.54 | $436.52 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $7,413.10 | Facility | None | $467.74 | $467.74 | $7,413.10 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $616.60 | Professional | None | $416.87 | $457.09 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $5,623.41 Typical High $7,943.28 | Facility | None | $691.83 | $5,623.41 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $912.01 | Professional | None | $467.74 | $562.34 | $912.01 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,148.15 Median $6,606.93 Typical High $9,332.54 | Facility | None | $1,148.15 | $6,606.93 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $831.76 | Professional | None | $467.74 | $630.96 | $831.76 |
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 $398.11 Median $524.81 Typical High $812.83 | Professional | None | $398.11 | $524.81 | $812.83 |
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 $223.87 Median $223.87 Typical High $316.23 | Professional | 52 · Reduced service | $223.87 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $125.89 | Professional | 53 · Discontinued | $89.13 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $478.63 | Professional | 54 · Surgery only | $331.13 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $95.50 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $63.10 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $63.10 |
Where Indiana sits
The same service costs 6.1 times more in Alaska 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
AK $8,625MT $1,416
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.