How much rates vary
Facilitymedian $1,950 · 10th to 90th $437 to $5,129Professionalmedian $275 · 10th to 90th $151 to $417
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 $173.78 Median $436.52 Typical High $5,011.87 | Facility | None | $173.78 | $436.52 | $5,011.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $112.20 Typical High $229.09 | Facility | 53 · Discontinued | $66.07 | $112.20 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $295.12 Typical High $346.74 | Professional | None | $151.36 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $75.86 Typical High $158.49 | Professional | 53 · Discontinued | $30.20 | $75.86 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | None | $138.04 | $144.54 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $5,888.44 | Facility | None | $616.60 | $3,235.94 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $346.74 | Professional | None | $144.54 | $269.15 | $346.74 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $123.03 Typical High $165.96 | Professional | 53 · Discontinued | $56.23 | $123.03 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $1,023.29 | Facility | None | $158.49 | $158.49 | $1,023.29 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $776.25 Typical High $1,445.44 | Facility | None | $407.38 | $776.25 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $501.19 | Professional | None | $162.18 | $295.12 | $501.19 |
Cigna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $158.49 Typical High $398.11 | Professional | 53 · Discontinued | $120.23 | $158.49 | $398.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $416.87 Median $1,071.52 Typical High $2,089.30 | Facility | None | $416.87 | $1,071.52 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $524.81 | Professional | None | $177.83 | $338.84 | $524.81 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $158.49 Typical High $263.03 | Professional | 53 · Discontinued | $89.13 | $158.49 | $263.03 |
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 $151.36 Median $269.15 Typical High $457.09 | Professional | None | $151.36 | $269.15 | $457.09 |
4 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 $75.86 Median $107.15 Typical High $158.49 | Professional | 52 · Reduced service | $75.86 | $107.15 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $218.78 Typical High $239.88 | Professional | 54 · Surgery only | $114.82 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $43.65 Typical High $47.86 | Professional | 55 · Aftercare only | $22.91 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $15.14 | $29.51 | $31.62 |
Where Indiana sits
The same service costs 4.7 times more in Connecticut than in North Dakota. 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
CT $3,190ND $672
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.