How much rates vary
Facilitymedian $4,898 · 10th to 90th $759 to $19,055Professionalmedian $427 · 10th to 90th $316 to $692
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 $323.59 Median $3,467.37 Typical High $5,623.41 | Facility | None | $323.59 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $457.09 | Professional | None | $323.59 | $398.11 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $10,964.78 Typical High $22,908.68 | Facility | None | $741.31 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $575.44 | Professional | None | $288.40 | $389.05 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $588.84 Typical High $870.96 | Professional | 50 · Both sides | $426.58 | $588.84 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $5,248.07 | Facility | None | $354.81 | $354.81 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $3,548.13 Typical High $5,888.44 | Facility | None | $407.38 | $3,548.13 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $1,000.00 | Professional | None | $363.08 | $501.19 | $1,000.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $4,570.88 Typical High $7,413.10 | Facility | None | $912.01 | $4,570.88 | $7,413.10 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $776.25 | Professional | None | $407.38 | $588.84 | $776.25 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $741.31 | Professional | None | $346.74 | $501.19 | $741.31 |
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 $162.18 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $162.18 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $79.43 Typical High $91.20 | Professional | 53 · Discontinued | $64.57 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $245.47 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $32.36 | $39.81 | $45.71 |
Where Indiana sits
The same service costs 6.3 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 $7,350MT $1,166
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.