How much rates vary
Facilitymedian $2,630 · 10th to 90th $513 to $8,318Professionalmedian $257 · 10th to 90th $214 to $550
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 $245.47 Median $5,011.87 Typical High $5,623.41 | Facility | None | $245.47 | $5,011.87 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $281.84 | Professional | None | $229.09 | $245.47 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $9,549.93 | Facility | None | $616.60 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $346.74 | Professional | None | $204.17 | $251.19 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $1,479.11 | Facility | None | $263.03 | $263.03 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,096.48 Typical High $1,659.59 | Facility | None | $407.38 | $1,096.48 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $1,778.28 | Professional | None | $257.04 | $371.54 | $1,778.28 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $676.08 Median $1,584.89 Typical High $2,344.23 | Facility | None | $676.08 | $1,584.89 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $478.63 | Professional | None | $257.04 | $363.08 | $478.63 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $676.08 | Professional | None | $218.78 | $316.23 | $676.08 |
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 $114.82 Median $123.03 Typical High $128.82 | Professional | 52 · Reduced service | $114.82 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $186.21 Typical High $190.55 | Professional | 54 · Surgery only | $169.82 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $37.15 Typical High $38.02 | Professional | 55 · Aftercare only | $33.88 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $25.70 |
Where Indiana sits
The same service costs 6.0 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 $4,737MT $787
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.