How much rates vary
Facilitymedian $1,995 · 10th to 90th $417 to $5,129Professionalmedian $155 · 10th to 90th $98 to $234
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 $97.72 Median $5,011.87 Typical High $5,623.41 | Facility | None | $97.72 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $123.03 | Professional | None | $97.72 | $97.72 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,162.28 Typical High $5,888.44 | Facility | None | $616.60 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $181.97 Typical High $239.88 | Professional | None | $93.33 | $181.97 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $776.25 | Facility | None | $114.82 | $114.82 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $489.78 Typical High $1,023.29 | Facility | None | $173.78 | $489.78 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $239.88 | Professional | None | $107.15 | $144.54 | $239.88 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $295.12 Median $870.96 Typical High $2,089.30 | Facility | None | $295.12 | $870.96 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $208.93 | Professional | None | $117.49 | $154.88 | $208.93 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,348.96 Typical High $3,801.89 | Facility | None | $398.11 | $1,348.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $208.93 | Professional | None | $100.00 | $141.25 | $208.93 |
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 $48.98 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $48.98 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $19.50 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | 54 · Surgery only | $72.44 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $12.02 |
Where Indiana sits
The same service costs 8.1 times more in New York 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
NY $2,852MT $352
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.