How much rates vary
Facilitymedian $6,166 · 10th to 90th $832 to $15,136Professionalmedian $380 · 10th to 90th $257 to $513
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 $275.42 Median $5,011.87 Typical High $11,220.18 | Facility | None | $275.42 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $446.68 Typical High $512.86 | Professional | None | $239.88 | $446.68 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $6,606.93 | Facility | None | $288.40 | $288.40 | $6,606.93 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $3,801.89 Typical High $7,079.46 | Facility | None | $446.68 | $3,801.89 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $630.96 | Professional | None | $288.40 | $380.19 | $630.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $741.31 Median $6,918.31 Typical High $9,332.54 | Facility | None | $741.31 | $6,918.31 | $9,332.54 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $524.81 | Professional | None | $295.12 | $389.05 | $524.81 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,230.27 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $512.86 | Professional | None | $245.47 | $331.13 | $512.86 |
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 $134.90 Median $134.90 Typical High $190.55 | Professional | 52 · Reduced service | $134.90 | $134.90 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | 53 · Discontinued | $54.95 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $288.40 | Professional | 54 · Surgery only | $204.17 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $38.02 |
Where Indiana sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.