How much rates vary
Facilitymedian $3,981 · 10th to 90th $724 to $14,125Professionalmedian $269 · 10th to 90th $195 to $380
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 $5,011.87 Typical High $5,623.41 | Facility | None | $204.17 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $269.15 | Professional | None | $204.17 | $204.17 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $7,413.10 Typical High $17,378.01 | Facility | None | $741.31 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $371.54 | Professional | None | $181.97 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $416.87 Typical High $562.34 | Professional | 50 · Both sides | $269.15 | $416.87 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $3,467.37 | Facility | None | $213.80 | $213.80 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $2,238.72 Typical High $3,715.35 | Facility | None | $407.38 | $2,238.72 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $436.52 | Professional | None | $208.93 | $263.03 | $436.52 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $575.44 Median $3,548.13 Typical High $5,011.87 | Facility | None | $575.44 | $3,548.13 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $398.11 | Professional | None | $213.80 | $263.03 | $398.11 |
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 $199.53 Median $251.19 Typical High $398.11 | Professional | None | $199.53 | $251.19 | $398.11 |
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 $102.33 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $40.74 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $144.54 | $144.54 | $173.78 |
Where Indiana sits
The same service costs 9.6 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 $6,197MT $647
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.