How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,514 to $19,055Professionalmedian $1,445 · 10th to 90th $1,202 to $2,239
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 $1,288.25 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,288.25 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,288.25 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $11,220.18 Typical High $22,908.68 | Facility | None | $1,737.80 | $11,220.18 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,445.44 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,187.76 Typical High $3,090.30 | Professional | 50 · Both sides | $1,737.80 | $2,187.76 | $3,090.30 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $6,025.60 | Facility | None | $1,380.38 | $1,380.38 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $6,456.54 | Facility | None | $1,258.93 | $3,630.78 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,659.59 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $2,089.30 Median $6,165.95 Typical High $8,511.38 | Facility | None | $2,089.30 | $6,165.95 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,698.24 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,513.56 | $2,630.27 |
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 $602.56 Median $645.65 Typical High $691.83 | Professional | 52 · Reduced service | $602.56 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $1,047.13 | Professional | 54 · Surgery only | $891.25 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $977.24 |
Where Indiana sits
The same service costs 3.0 times more in Alaska than in Vermont. 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 $12,999VT $4,294
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.