How much rates vary
Facilitymedian $1,820 · 10th to 90th $204 to $5,129Professionalmedian $214 · 10th to 90th $132 to $347
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 $128.82 Median $3,467.37 Typical High $5,623.41 | Facility | None | $128.82 | $3,467.37 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $245.47 | Professional | None | $128.82 | $208.93 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,888.44 | Facility | None | $602.56 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $346.74 | Professional | None | $138.04 | $234.42 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $269.15 | Facility | None | $138.04 | $138.04 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $794.33 | Facility | None | $165.96 | $275.42 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $354.81 | Professional | None | $138.04 | $208.93 | $354.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $229.09 Median $354.81 Typical High $954.99 | Facility | None | $229.09 | $354.81 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $389.05 | Professional | None | $141.25 | $234.42 | $389.05 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $363.08 | Professional | None | $138.04 | $218.78 | $363.08 |
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 $64.57 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $64.57 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $25.70 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $97.72 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $19.50 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.88 | $20.89 | $24.55 |
Where Indiana sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.