How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $19,498Professionalmedian $468 · 10th to 90th $389 to $708
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 $489.78 Median $645.65 Typical High $9,549.93 | Facility | None | $489.78 | $645.65 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $660.69 | Professional | None | $457.09 | $467.74 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | None | $398.11 | $478.63 | $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 $389.05 Median $457.09 Typical High $549.54 | Professional | None | $389.05 | $457.09 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $7,413.10 | Facility | None | $489.78 | $489.78 | $7,413.10 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $489.78 Median $588.84 Typical High $954.99 | Professional | None | $489.78 | $588.84 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,202.26 Median $6,606.93 Typical High $9,332.54 | Facility | None | $1,202.26 | $6,606.93 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $851.14 | Professional | None | $489.78 | $645.65 | $851.14 |
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 $416.87 Median $549.54 Typical High $851.14 | Professional | None | $416.87 | $549.54 | $851.14 |
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 $234.42 Median $234.42 Typical High $331.13 | Professional | 52 · Reduced service | $234.42 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $131.83 | Professional | 53 · Discontinued | $93.33 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $354.81 Typical High $501.19 | Professional | 54 · Surgery only | $346.74 | $354.81 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $70.79 Typical High $100.00 | Professional | 55 · Aftercare only | $69.18 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $66.07 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $66.07 |
Where Indiana sits
The same service costs 5.9 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 $8,723MT $1,483
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.