How much rates vary
Facilitymedian $1,622 · 10th to 90th $132 to $5,129Professionalmedian $126 · 10th to 90th $100 to $219
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 $123.03 Median $162.18 Typical High $5,495.41 | Facility | None | $123.03 | $162.18 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $181.97 | Professional | None | $109.65 | $125.89 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $120.23 Typical High $120.23 | Professional | None | $60.26 | $120.23 | $120.23 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $181.97 Typical High $295.12 | Professional | 50 · Both sides | $181.97 | $181.97 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $3,235.94 Typical High $6,165.95 | Facility | None | $616.60 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $158.49 | Professional | None | $93.33 | $109.65 | $158.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $165.96 Typical High $234.42 | Professional | 50 · Both sides | $141.25 | $165.96 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Facility | None | $120.23 | $120.23 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $173.78 | Professional | None | $123.03 | $134.90 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $173.78 Typical High $794.33 | Facility | None | $104.71 | $173.78 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $338.84 | Professional | None | $125.89 | $162.18 | $338.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $147.91 Median $302.00 Typical High $954.99 | Facility | None | $147.91 | $302.00 | $954.99 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $245.47 | Professional | None | $125.89 | $186.21 | $245.47 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $229.09 | Professional | None | $102.33 | $141.25 | $229.09 |
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 $54.95 Median $58.88 Typical High $67.61 | Professional | 52 · Reduced service | $54.95 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $26.92 | Professional | 53 · Discontinued | $21.88 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $89.13 Typical High $102.33 | Professional | 54 · Surgery only | $81.28 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.78 Typical High $20.42 | Professional | 55 · Aftercare only | $16.22 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.96 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $75.86 | $83.18 | $95.50 |
Where Indiana sits
The same service costs 4.2 times more in Alaska than in Florida. 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.
Indiana· 46th of 51
$135
AK $490FL $117
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.