How much rates vary
Facilitymedian $10,233 · 10th to 90th $1,445 to $25,704Professionalmedian $4,074 · 10th to 90th $407 to $8,511
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 $436.52 Median $5,011.87 Typical High $19,498.45 | Facility | None | $436.52 | $5,011.87 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $5,128.61 Typical High $6,025.60 | Professional | None | $436.52 | $5,128.61 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $10,715.19 Typical High $28,840.32 | Facility | None | $1,778.28 | $10,715.19 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $4,466.84 Typical High $7,244.36 | Professional | None | $407.38 | $4,466.84 | $7,244.36 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $14,791.08 | Facility | None | $457.09 | $457.09 | $14,791.08 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $10,000.00 Typical High $16,595.87 | Facility | None | $691.83 | $10,000.00 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $1,023.29 Typical High $10,232.93 | Professional | None | $467.74 | $1,023.29 | $10,232.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,202.26 Median $15,135.61 Typical High $17,378.01 | Facility | None | $1,202.26 | $15,135.61 | $17,378.01 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,258.93 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $446.68 Median $4,570.88 Typical High $10,000.00 | Professional | None | $446.68 | $4,570.88 | $10,000.00 |
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 $218.78 Median $2,511.89 Typical High $2,951.21 | Professional | 52 · Reduced service | $218.78 | $2,511.89 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $1,023.29 Typical High $1,174.90 | Professional | 53 · Discontinued | $89.13 | $1,023.29 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $3,801.89 Typical High $4,466.84 | Professional | 54 · Surgery only | $331.13 | $3,801.89 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $758.58 Typical High $891.25 | Professional | 55 · Aftercare only | $66.07 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $512.86 Typical High $588.84 | Professional | 56 · Pre-op care only | $43.65 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $3,548.13 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $309.03 | $3,548.13 | $4,168.69 |
Where Indiana sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.