How much rates vary
Facilitymedian $2,818 · 10th to 90th $603 to $8,318Professionalmedian $347 · 10th to 90th $282 to $575
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 $346.74 Median $2,344.23 Typical High $7,244.36 | Facility | None | $346.74 | $2,344.23 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $478.63 | Professional | None | $346.74 | $346.74 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $446.68 | Professional | None | $281.84 | $331.13 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $2,137.96 | Facility | None | $363.08 | $363.08 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,318.26 Typical High $2,290.87 | Facility | None | $407.38 | $1,318.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $588.84 | Professional | None | $257.04 | $371.54 | $588.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $3,388.44 | Facility | None | $912.01 | $2,187.76 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $676.08 | Professional | None | $407.38 | $537.03 | $676.08 |
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 $302.00 Median $398.11 Typical High $691.83 | Professional | None | $302.00 | $398.11 | $691.83 |
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 $169.82 Median $169.82 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $281.84 |
Where Indiana sits
The same service costs 4.5 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 $4,914MT $1,099
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.