How much rates vary
Facilitymedian $20,893 · 10th to 90th $631 to $56,234Professionalmedian $490 · 10th to 90th $339 to $741
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 $426.58 Median $467.74 Typical High $7,244.36 | Facility | None | $426.58 | $467.74 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $446.68 | Professional | None | $338.84 | $354.81 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $32,359.37 Typical High $66,069.34 | Facility | None | $851.14 | $32,359.37 | $66,069.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $676.08 | Professional | None | $338.84 | $549.54 | $676.08 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $213.80 Median $346.74 Typical High $426.58 | Professional | 62 · Two surgeons | $213.80 | $346.74 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $30,199.52 | Facility | None | $398.11 | $398.11 | $30,199.52 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $22,908.68 Typical High $33,113.11 | Facility | None | $549.54 | $22,908.68 | $33,113.11 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $4,073.80 | Professional | None | $371.54 | $512.86 | $4,073.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,023.29 Median $25,703.96 Typical High $38,904.51 | Facility | None | $1,023.29 | $25,703.96 | $38,904.51 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $758.58 | Professional | None | $407.38 | $549.54 | $758.58 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $12,882.50 Typical High $43,651.58 | Facility | None | $2,398.83 | $12,882.50 | $43,651.58 |
United Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $724.44 | Professional | None | $309.03 | $436.52 | $724.44 |
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 $169.82 Median $177.83 Typical High $199.53 | Professional | 52 · Reduced service | $169.82 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $70.79 Typical High $79.43 | Professional | 53 · Discontinued | $67.61 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $257.04 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $51.29 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.88 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $245.47 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $239.88 | $245.47 | $275.42 |
Where Indiana sits
The same service costs 29.4 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 $37,066MT $1,262
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.