How much rates vary
Facilitymedian $2,188 · 10th to 90th $490 to $8,318Professionalmedian $245 · 10th to 90th $155 to $331
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 $165.96 Median $3,801.89 Typical High $5,623.41 | Facility | None | $165.96 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $234.42 | Professional | None | $165.96 | $165.96 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $288.40 Typical High $323.59 | Professional | None | $141.25 | $288.40 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $1,318.26 | Facility | None | $169.82 | $169.82 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $812.83 Typical High $1,659.59 | Facility | None | $309.03 | $812.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $426.58 | Professional | None | $177.83 | $263.03 | $426.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $457.09 Median $1,412.54 Typical High $2,290.87 | Facility | None | $457.09 | $1,412.54 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $316.23 | Professional | None | $177.83 | $234.42 | $316.23 |
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 $147.91 Median $229.09 Typical High $354.81 | Professional | None | $147.91 | $229.09 | $354.81 |
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 $83.18 Median $83.18 Typical High $117.49 | Professional | 52 · Reduced service | $83.18 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $46.77 | Professional | 53 · Discontinued | $33.11 | $33.11 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $125.89 Typical High $173.78 | Professional | 54 · Surgery only | $123.03 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.12 Typical High $35.48 | Professional | 55 · Aftercare only | $24.55 | $25.12 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $23.44 |
Where Indiana sits
The same service costs 7.7 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 $4,047MT $526
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.