How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,122 to $20,417Professionalmedian $1,905 · 10th to 90th $1,479 to $2,884
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 $1,905.46 Median $2,137.96 Typical High $5,011.87 | Facility | None | $1,905.46 | $2,137.96 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,737.80 | $1,905.46 | $2,238.72 |
Ambetter Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $12,589.25 Typical High $21,379.62 | Facility | None | $1,659.59 | $12,589.25 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,479.11 | $1,737.80 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $426.58 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $245.47 Typical High $346.74 | Professional | AS · PA/NP assist | $204.17 | $245.47 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,089.30 Typical High $3,090.30 | Facility | None | $575.44 | $2,089.30 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,290.87 | $2,884.03 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $4,897.79 | Facility | None | $912.01 | $2,089.30 | $4,897.79 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,949.84 | $2,344.23 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,290.87 | $3,548.13 |
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 $870.96 Median $954.99 Typical High $1,122.02 | Professional | 52 · Reduced service | $870.96 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $380.19 Typical High $446.68 | Professional | 53 · Discontinued | $346.74 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,412.54 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,288.25 | $1,412.54 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $281.84 Typical High $338.84 | Professional | 55 · Aftercare only | $263.03 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $190.55 Typical High $223.87 | Professional | 56 · Pre-op care only | $173.78 | $190.55 | $223.87 |
Where Indiana sits
The same service costs 8.4 times more in Maine than in Arkansas. 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
ME $28,933AR $3,447
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.