How much rates vary
Facilitymedian $2,138 · 10th to 90th $126 to $5,248Professionalmedian $123 · 10th to 90th $98 to $209
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 $109.65 Median $3,801.89 Typical High $5,623.41 | Facility | None | $109.65 | $3,801.89 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $177.83 | Professional | None | $109.65 | $138.04 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $134.90 | Professional | None | $67.61 | $125.89 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | None | $95.50 | $114.82 | $138.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $169.82 Typical High $208.93 | Professional | 50 · Both sides | $144.54 | $169.82 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $190.55 | Facility | None | $114.82 | $114.82 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $151.36 | Professional | None | $128.82 | $131.83 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $147.91 Typical High $251.19 | Facility | None | $66.07 | $147.91 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $269.15 | Professional | None | $91.20 | $138.04 | $269.15 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $147.91 Median $295.12 Typical High $977.24 | Facility | None | $147.91 | $295.12 | $977.24 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $263.03 | Professional | None | $138.04 | $194.98 | $263.03 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $245.47 | Professional | None | $112.20 | $151.36 | $245.47 |
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 $54.95 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $54.95 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $27.54 Typical High $32.36 | Professional | 53 · Discontinued | $21.88 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $120.23 | Professional | 54 · Surgery only | $83.18 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.42 Typical High $23.99 | Professional | 55 · Aftercare only | $16.60 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.80 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.96 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $95.50 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $77.62 | $95.50 | $112.20 |
Where Indiana sits
The same service costs 4.1 times more in Alaska than in Florida. 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.
Indiana· 45th of 51
$132
AK $468FL $115
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.