How much rates vary
Facilitymedian $3,631 · 10th to 90th $661 to $8,318Professionalmedian $490 · 10th to 90th $186 to $1,259
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 $204.17 Median $1,174.90 Typical High $7,244.36 | Facility | None | $204.17 | $1,174.90 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $691.83 Typical High $954.99 | Professional | None | $186.21 | $691.83 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $181.97 Median $562.34 Typical High $1,230.27 | Professional | None | $181.97 | $562.34 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $3,467.37 | Facility | None | $208.93 | $208.93 | $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 $181.97 Median $380.19 Typical High $1,412.54 | Professional | None | $181.97 | $380.19 | $1,412.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $537.03 Median $3,019.95 Typical High $5,011.87 | Facility | None | $537.03 | $3,019.95 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $1,318.26 | Professional | None | $239.88 | $407.38 | $1,318.26 |
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 $186.21 Median $588.84 Typical High $1,412.54 | Professional | None | $186.21 | $588.84 | $1,412.54 |
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 $93.33 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $93.33 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $138.04 Typical High $154.88 | Professional | 53 · Discontinued | $38.02 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $512.86 Typical High $588.84 | Professional | 54 · Surgery only | $141.25 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $28.18 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $18.62 | $69.18 | $77.62 |
Where Indiana sits
The same service costs 3.8 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 $5,124MT $1,344
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.