How much rates vary
Facilitymedian $2,692 · 10th to 90th $603 to $8,318Professionalmedian $155 · 10th to 90th $63 to $661
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 $69.18 Median $2,344.23 Typical High $5,623.41 | Facility | None | $69.18 | $2,344.23 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $501.19 Typical High $588.84 | Professional | None | $69.18 | $501.19 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $154.88 Typical High $512.86 | Professional | None | $60.26 | $154.88 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $1,778.28 | Facility | None | $70.79 | $70.79 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,412.54 Typical High $2,511.89 | Facility | None | $630.96 | $1,412.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $891.25 | Professional | None | $74.13 | $138.04 | $891.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $186.21 Median $1,862.09 Typical High $2,754.23 | Facility | None | $186.21 | $1,862.09 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $933.25 | Professional | None | $81.28 | $223.87 | $933.25 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $69.18 Median $371.54 Typical High $776.25 | Professional | None | $69.18 | $371.54 | $776.25 |
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 $34.67 Median $251.19 Typical High $295.12 | Professional | 52 · Reduced service | $34.67 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $13.80 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $52.48 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $10.47 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $6.92 | $50.12 | $58.88 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 59 · Distinct service | $60.26 | $60.26 | $60.26 |
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 $4,728MT $843
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.