How much rates vary
Facilitymedian $10,000 · 10th to 90th $1,175 to $39,811Professionalmedian $1,072 · 10th to 90th $646 to $1,660
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 $645.65 Median $5,011.87 Typical High $14,125.38 | Facility | None | $645.65 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $977.24 | Professional | None | $645.65 | $645.65 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $21,877.62 Typical High $45,708.82 | Facility | None | $1,412.54 | $21,877.62 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $1,258.93 Typical High $1,659.59 | Professional | None | $588.84 | $1,258.93 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,905.46 Typical High $2,570.40 | Professional | 50 · Both sides | $891.25 | $1,905.46 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $10,000.00 | Facility | None | $707.95 | $707.95 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $6,456.54 Typical High $10,715.19 | Facility | None | $630.96 | $6,456.54 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,659.59 | Professional | None | $812.83 | $1,096.48 | $1,659.59 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,778.28 Median $10,232.93 Typical High $16,982.44 | Facility | None | $1,778.28 | $10,232.93 | $16,982.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,348.96 | Professional | None | $724.44 | $1,047.13 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,621.81 | Professional | None | $776.25 | $1,023.29 | $1,621.81 |
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 $323.59 Median $323.59 Typical High $457.09 | Professional | 52 · Reduced service | $323.59 | $323.59 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $181.97 | Professional | 53 · Discontinued | $128.82 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $691.83 | Professional | 54 · Surgery only | $489.78 | $489.78 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $138.04 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $91.20 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $645.65 |
Where Indiana sits
The same service costs 6.6 times more in Colorado than in Kentucky. 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 $14,612KY $2,222
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.