How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,000 to $14,125Professionalmedian $631 · 10th to 90th $513 to $891
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 $575.44 Median $5,011.87 Typical High $14,125.38 | Facility | None | $575.44 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $812.83 | Professional | None | $575.44 | $575.44 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $758.58 | Professional | None | $512.86 | $660.69 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $416.87 Typical High $478.63 | Professional | 62 · Two surgeons | $323.59 | $416.87 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $3,467.37 | Facility | None | $616.60 | $616.60 | $3,467.37 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $3,715.35 | Facility | None | $691.83 | $2,137.96 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,096.48 | Professional | None | $562.34 | $630.96 | $1,096.48 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,318.26 Median $3,630.78 Typical High $5,754.40 | Facility | None | $1,318.26 | $3,630.78 | $5,754.40 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,023.29 | Professional | None | $630.96 | $831.76 | $1,023.29 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $933.25 | Professional | None | $489.78 | $616.60 | $933.25 |
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 $288.40 Median $288.40 Typical High $389.05 | Professional | 52 · Reduced service | $288.40 | $288.40 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | 53 · Discontinued | $114.82 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | 54 · Surgery only | $426.58 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $77.62 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $549.54 |
Where Indiana sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.