How much rates vary
Facilitymedian $3,890 · 10th to 90th $724 to $9,120Professionalmedian $417 · 10th to 90th $295 to $589
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 $346.74 Median $398.11 Typical High $11,220.18 | Facility | None | $346.74 | $398.11 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $426.58 | Professional | None | $323.59 | $323.59 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $933.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $562.34 | Professional | None | $288.40 | $416.87 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $630.96 Typical High $851.14 | Professional | 50 · Both sides | $426.58 | $630.96 | $851.14 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $3,467.37 | Facility | None | $338.84 | $338.84 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,454.71 Typical High $3,715.35 | Facility | None | $630.96 | $2,454.71 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $660.69 | Professional | None | $309.03 | $407.38 | $660.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,548.13 Typical High $5,011.87 | Facility | None | $912.01 | $3,548.13 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $630.96 | Professional | None | $338.84 | $416.87 | $630.96 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $616.60 | Professional | None | $309.03 | $389.05 | $616.60 |
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 $162.18 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $64.57 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $239.88 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $269.15 |
Where Indiana sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.