How much rates vary
Facilitymedian $3,548 · 10th to 90th $891 to $8,913Professionalmedian $794 · 10th to 90th $617 to $1,202
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 $676.08 Median $5,011.87 Typical High $11,220.18 | Facility | None | $676.08 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $758.58 | Professional | None | $588.84 | $676.08 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,047.13 | Professional | None | $616.60 | $794.33 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $1,905.46 | Facility | None | $741.31 | $741.31 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,445.44 Typical High $2,691.53 | Facility | None | $630.96 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $4,073.80 | Professional | None | $660.69 | $870.96 | $4,073.80 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $3,090.30 | Facility | None | $1,071.52 | $2,089.30 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,380.38 | Professional | None | $691.83 | $1,000.00 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,288.25 | Professional | None | $588.84 | $758.58 | $1,288.25 |
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 $323.59 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $323.59 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $512.86 |
Where Indiana sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.