How much rates vary
Facilitymedian $2,884 · 10th to 90th $589 to $14,125Professionalmedian $363 · 10th to 90th $309 to $562
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 $380.19 Median $426.58 Typical High $9,549.93 | Facility | None | $380.19 | $426.58 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $512.86 | Professional | None | $363.08 | $363.08 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $467.74 | Professional | None | $371.54 | $371.54 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,096.48 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $436.52 | Professional | None | $309.03 | $363.08 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $1,778.28 | Facility | None | $380.19 | $380.19 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,513.56 Typical High $2,884.03 | Facility | None | $691.83 | $1,513.56 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $758.58 | Professional | None | $380.19 | $467.74 | $758.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $933.25 Median $1,995.26 Typical High $3,548.13 | Facility | None | $933.25 | $1,995.26 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $676.08 | Professional | None | $380.19 | $512.86 | $676.08 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $676.08 | Professional | None | $323.59 | $426.58 | $676.08 |
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 $181.97 Median $181.97 Typical High $257.04 | Professional | 52 · Reduced service | $181.97 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $102.33 | Professional | 53 · Discontinued | $72.44 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $275.42 Typical High $389.05 | Professional | 54 · Surgery only | $269.15 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $51.29 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $51.29 |
Where Indiana sits
The same service costs 5.0 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 $5,749MT $1,151
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.