How much rates vary
Facilitymedian $2,692 · 10th to 90th $603 to $8,318Professionalmedian $355 · 10th to 90th $257 to $501
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 $275.42 Median $5,011.87 Typical High $7,244.36 | Facility | None | $275.42 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | None | $275.42 | $275.42 | $389.05 |
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 $234.42 Median $436.52 Typical High $467.74 | Professional | None | $234.42 | $436.52 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $1,778.28 | Facility | None | $288.40 | $288.40 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,318.26 Typical High $2,187.76 | Facility | None | $562.34 | $1,318.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $602.56 | Professional | None | $288.40 | $338.84 | $602.56 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $741.31 Median $1,949.84 Typical High $2,754.23 | Facility | None | $741.31 | $1,949.84 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $512.86 | Professional | None | $288.40 | $398.11 | $512.86 |
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 $245.47 Median $316.23 Typical High $501.19 | Professional | None | $245.47 | $316.23 | $501.19 |
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 $138.04 Median $138.04 Typical High $190.55 | Professional | 52 · Reduced service | $138.04 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $208.93 Typical High $281.84 | Professional | 54 · Surgery only | $204.17 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $41.69 Typical High $56.23 | Professional | 55 · Aftercare only | $40.74 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $38.02 |
Where Indiana sits
The same service costs 5.2 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 $4,508MT $873
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.