How much rates vary
Facilitymedian $3,311 · 10th to 90th $575 to $8,318Professionalmedian $479 · 10th to 90th $174 to $1,288
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 $186.21 Median $891.25 Typical High $5,011.87 | Facility | None | $186.21 | $891.25 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $645.65 Typical High $933.25 | Professional | None | $162.18 | $645.65 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $512.86 Typical High $1,288.25 | Professional | None | $208.93 | $512.86 | $1,288.25 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $3,467.37 | Facility | None | $177.83 | $177.83 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,238.72 Typical High $3,715.35 | Facility | None | $549.54 | $2,238.72 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $416.87 Typical High $1,621.81 | Professional | None | $186.21 | $416.87 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $467.74 Median $3,019.95 Typical High $5,011.87 | Facility | None | $467.74 | $3,019.95 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $208.93 Median $354.81 Typical High $1,258.93 | Professional | None | $208.93 | $354.81 | $1,258.93 |
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 $181.97 Median $512.86 Typical High $1,380.38 | Professional | None | $181.97 | $512.86 | $1,380.38 |
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 $81.28 Median $323.59 Typical High $371.54 | Professional | 52 · Reduced service | $81.28 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $32.36 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $489.78 Typical High $562.34 | Professional | 54 · Surgery only | $123.03 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $24.55 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $64.57 Typical High $74.13 | Professional | 56 · Pre-op care only | $16.22 | $64.57 | $74.13 |
Where Indiana sits
The same service costs 4.0 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 $5,041MT $1,267
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.