How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,445 to $19,055Professionalmedian $1,259 · 10th to 90th $871 to $1,778
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 $933.25 Median $5,011.87 Typical High $17,782.79 | Facility | None | $933.25 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,148.15 | Professional | None | $891.25 | $933.25 | $1,148.15 |
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 $851.14 Median $1,258.93 Typical High $1,698.24 | Professional | None | $851.14 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,905.46 Typical High $2,570.40 | Professional | 50 · Both sides | $1,258.93 | $1,905.46 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $6,025.60 | Facility | None | $1,047.13 | $1,047.13 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,467.37 Typical High $6,309.57 | Facility | None | $1,148.15 | $3,467.37 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,905.46 | Professional | None | $977.24 | $1,230.27 | $1,905.46 |
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 $1,023.29 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,258.93 | $1,862.09 |
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 $954.99 Median $1,174.90 Typical High $1,995.26 | Professional | None | $954.99 | $1,174.90 | $1,995.26 |
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 $446.68 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $707.95 |
Where Indiana sits
The same service costs 3.6 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 $11,248MT $3,134
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.