How much rates vary
Facilitymedian $3,631 · 10th to 90th $794 to $8,511Professionalmedian $288 · 10th to 90th $195 to $427
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 $331.13 Median $5,011.87 Typical High $7,244.36 | Facility | None | $331.13 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $467.74 | Professional | None | $323.59 | $331.13 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $194.98 Median $275.42 Typical High $323.59 | Professional | None | $194.98 | $275.42 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $2,884.03 | Facility | None | $346.74 | $346.74 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $3,090.30 | Facility | None | $630.96 | $2,187.76 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $537.03 | Professional | None | $181.97 | $288.40 | $537.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,511.89 Typical High $3,981.07 | Facility | None | $912.01 | $2,511.89 | $3,981.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $602.56 | Professional | None | $302.00 | $467.74 | $602.56 |
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 $204.17 Median $295.12 Typical High $457.09 | Professional | None | $204.17 | $295.12 | $457.09 |
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 $162.18 Median $165.96 Typical High $213.80 | Professional | 52 · Reduced service | $162.18 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $64.57 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $323.59 | Professional | 54 · Surgery only | $245.47 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.11 Typical High $43.65 | Professional | 56 · Pre-op care only | $32.36 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $234.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $229.09 | $234.42 | $302.00 |
Where Indiana sits
The same service costs 5.5 times more in Colorado than in Michigan. 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 $4,792MI $877
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.