How much rates vary
Facilitymedian $3,090 · 10th to 90th $631 to $8,318Professionalmedian $224 · 10th to 90th $155 to $457
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 $169.82 Median $2,041.74 Typical High $7,244.36 | Facility | None | $169.82 | $2,041.74 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $309.03 Typical High $371.54 | Professional | None | $169.82 | $309.03 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $147.91 Median $223.87 Typical High $295.12 | Professional | None | $147.91 | $223.87 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $331.13 Typical High $446.68 | Professional | 50 · Both sides | $223.87 | $331.13 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $2,137.96 | Facility | None | $181.97 | $181.97 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,659.59 Typical High $2,344.23 | Facility | None | $562.34 | $1,659.59 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $501.19 | Professional | None | $141.25 | $234.42 | $501.19 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $457.09 Median $1,905.46 Typical High $3,388.44 | Facility | None | $457.09 | $1,905.46 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $588.84 | Professional | None | $208.93 | $380.19 | $588.84 |
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 $173.78 Median $295.12 Typical High $512.86 | Professional | None | $173.78 | $295.12 | $512.86 |
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 $85.11 Median $154.88 Typical High $186.21 | Professional | 52 · Reduced service | $85.11 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $33.88 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $128.82 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $25.70 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $30.90 Typical High $37.15 | Professional | 56 · Pre-op care only | $16.98 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $218.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $120.23 | $218.78 | $257.04 |
Where Indiana sits
The same service costs 6.3 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 $4,654MT $736
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.