How much rates vary
Facilitymedian $12,882 · 10th to 90th $1,349 to $46,774Professionalmedian $1,230 · 10th to 90th $977 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 $3,801.89 Median $10,471.29 Typical High $19,054.61 | Facility | None | $3,801.89 | $10,471.29 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $10,000.00 | Professional | None | $977.24 | $1,230.27 | $10,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,589.25 Median $22,387.21 Typical High $38,018.94 | Facility | None | $12,589.25 | $22,387.21 | $38,018.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,479.11 | Professional | None | $977.24 | $1,174.90 | $1,479.11 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,230.27 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $6,025.60 Median $12,882.50 Typical High $46,773.51 | Facility | None | $6,025.60 | $12,882.50 | $46,773.51 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,445.44 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,318.26 | Professional | None | $891.25 | $1,023.29 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,995.26 | Facility | None | $1,230.27 | $1,621.81 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,454.71 Typical High $40,738.03 | Facility | None | $933.25 | $2,454.71 | $40,738.03 |
Sentara Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $11,481.54 | Professional | None | $1,122.02 | $1,548.82 | $11,481.54 |
United Setting Facility Modifier None Typical Low $10,000.00 Median $22,908.68 Typical High $64,565.42 | Facility | None | $10,000.00 | $22,908.68 | $64,565.42 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,548.82 Typical High $2,290.87 | Professional | None | $954.99 | $1,548.82 | $2,290.87 |
5 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 $489.78 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $194.98 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $123.03 | $123.03 |
Where Virginia sits
The same service costs 8.1 times more in Indiana than in Kentucky. 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
IN $23,026KY $2,834
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.