How much rates vary
Facilitymedian $4,467 · 10th to 90th $724 to $14,454Professionalmedian $417 · 10th to 90th $316 to $617
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 $363.08 Median $3,801.89 Typical High $5,623.41 | Facility | None | $363.08 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $478.63 | Professional | None | $363.08 | $363.08 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $302.00 | Professional | None | $239.88 | $302.00 | $302.00 |
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 $316.23 Median $416.87 Typical High $575.44 | Professional | None | $316.23 | $416.87 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $3,467.37 | Facility | None | $371.54 | $371.54 | $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 $346.74 Median $457.09 Typical High $724.44 | Professional | None | $346.74 | $457.09 | $724.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,548.13 Typical High $5,011.87 | Facility | None | $954.99 | $3,548.13 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $707.95 | Professional | None | $380.19 | $457.09 | $707.95 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $660.69 | Professional | None | $338.84 | $426.58 | $660.69 |
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 $177.83 Median $177.83 Typical High $213.80 | Professional | 52 · Reduced service | $177.83 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $302.00 |
Where Indiana sits
The same service costs 5.9 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 $6,847MT $1,164
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.