How much rates vary
Facilitymedian $4,365 · 10th to 90th $794 to $19,055Professionalmedian $871 · 10th to 90th $646 to $1,288
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 $776.25 Median $954.99 Typical High $5,623.41 | Facility | None | $776.25 | $954.99 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,047.13 | Professional | None | $776.25 | $776.25 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $10,964.78 Typical High $22,908.68 | Facility | None | $776.25 | $10,964.78 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,174.90 | Professional | None | $676.08 | $870.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,288.25 Typical High $1,737.80 | Professional | 50 · Both sides | $1,023.29 | $1,288.25 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $4,365.16 | Facility | None | $794.33 | $794.33 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,818.38 Typical High $4,786.30 | Facility | None | $446.68 | $2,818.38 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,318.26 | Professional | None | $524.81 | $831.76 | $1,318.26 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,801.89 Typical High $7,079.46 | Facility | None | $954.99 | $3,801.89 | $7,079.46 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,479.11 | Professional | None | $891.25 | $1,202.26 | $1,479.11 |
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 $645.65 Median $851.14 Typical High $1,380.38 | Professional | None | $645.65 | $851.14 | $1,380.38 |
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 $389.05 Median $389.05 Typical High $457.09 | Professional | 52 · Reduced service | $389.05 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | 53 · Discontinued | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $575.44 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $630.96 |
Where Indiana sits
The same service costs 5.4 times more in Alaska than in South Carolina. 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 $8,807SC $1,633
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.