How much rates vary
Facilitymedian $2,884 · 10th to 90th $631 to $8,318Professionalmedian $269 · 10th to 90th $204 to $398
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 $245.47 Median $5,011.87 Typical High $7,244.36 | Facility | None | $245.47 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $346.74 | Professional | None | $245.47 | $245.47 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,370.32 Typical High $9,549.93 | Facility | None | $741.31 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $338.84 | Professional | None | $199.53 | $295.12 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $1,318.26 | Facility | None | $251.19 | $251.19 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,000.00 Typical High $1,995.26 | Facility | None | $524.81 | $1,000.00 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $1,047.13 | Professional | None | $234.42 | $288.40 | $1,047.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $660.69 Median $1,380.38 Typical High $1,698.24 | Facility | None | $660.69 | $1,380.38 | $1,698.24 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $398.11 | Professional | None | $257.04 | $316.23 | $398.11 |
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 $218.78 Median $288.40 Typical High $446.68 | Professional | None | $218.78 | $288.40 | $446.68 |
6 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 $123.03 Median $123.03 Typical High $173.78 | Professional | 52 · Reduced service | $123.03 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $69.18 | Professional | 53 · Discontinued | $48.98 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $257.04 | Professional | 54 · Surgery only | $181.97 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $51.29 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $34.67 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $34.67 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Where Indiana sits
The same service costs 5.6 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 $4,320MT $769
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.