How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,175 to $19,498Professionalmedian $631 · 10th to 90th $537 to $1,000
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 $630.96 Median $5,011.87 Typical High $11,220.18 | Facility | None | $630.96 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $11,481.54 Typical High $23,442.29 | Facility | None | $1,445.44 | $11,481.54 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $851.14 | Professional | None | $537.03 | $630.96 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $954.99 Typical High $1,288.25 | Professional | 50 · Both sides | $812.83 | $954.99 | $1,288.25 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $7,762.47 | Facility | None | $676.08 | $676.08 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,248.07 Typical High $8,709.64 | Facility | None | $645.65 | $5,248.07 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $977.24 | Professional | None | $537.03 | $758.58 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $7,079.46 Typical High $9,772.37 | Facility | None | $954.99 | $7,079.46 | $9,772.37 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,230.27 | Professional | None | $758.58 | $1,000.00 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,258.93 | $4,677.35 | $12,022.64 |
United Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,412.54 | Professional | None | $645.65 | $794.33 | $1,412.54 |
5 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 $316.23 Median $316.23 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $75.86 |
Where Indiana sits
The same service costs 5.9 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 $12,304MT $2,095
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.