How much rates vary
Facilitymedian $2,951 · 10th to 90th $575 to $8,318Professionalmedian $275 · 10th to 90th $182 to $589
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 $181.97 Median $512.86 Typical High $5,495.41 | Facility | None | $181.97 | $512.86 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $363.08 Typical High $512.86 | Professional | None | $181.97 | $363.08 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $426.58 | Professional | None | $151.36 | $162.18 | $426.58 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $389.05 Typical High $602.56 | Professional | 50 · Both sides | $229.09 | $389.05 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $338.84 | Professional | None | $162.18 | $275.42 | $338.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $416.87 Typical High $549.54 | Professional | 50 · Both sides | $245.47 | $416.87 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $1,905.46 | Facility | None | $194.98 | $194.98 | $1,905.46 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $549.54 | Professional | None | $380.19 | $426.58 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $2,238.72 | Facility | None | $575.44 | $1,412.54 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $794.33 | Professional | None | $234.42 | $416.87 | $794.33 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $524.81 Median $2,041.74 Typical High $3,090.30 | Facility | None | $524.81 | $2,041.74 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $724.44 | Professional | None | $208.93 | $389.05 | $724.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $660.69 | Professional | None | $199.53 | $363.08 | $660.69 |
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 $89.13 Median $169.82 Typical High $208.93 | Professional | 52 · Reduced service | $89.13 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $67.61 Typical High $83.18 | Professional | 53 · Discontinued | $36.31 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $134.90 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $26.92 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $33.88 Typical High $41.69 | Professional | 56 · Pre-op care only | $18.20 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $125.89 | $239.88 | $295.12 |
Where Indiana sits
The same service costs 4.6 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 $4,728MT $1,029
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.