How much rates vary
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 $186.21 Median $5,011.87 Typical High $7,244.36 | Facility | None | $186.21 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $281.84 | Professional | None | $181.97 | $208.93 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $9,549.93 | Facility | None | $660.69 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $331.13 | Professional | None | $151.36 | $213.80 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $363.08 | Facility | None | $190.55 | $190.55 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $288.40 Typical High $489.78 | Facility | None | $66.07 | $288.40 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $426.58 | Professional | None | $199.53 | $281.84 | $426.58 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,630.27 | Facility | None | $323.59 | $524.81 | $2,630.27 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $407.38 | Professional | None | $190.55 | $316.23 | $407.38 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,089.30 Typical High $4,677.35 | Facility | None | $512.86 | $2,089.30 | $4,677.35 |
United Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $426.58 | Professional | None | $169.82 | $251.19 | $426.58 |
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 $91.20 Median $104.71 Typical High $141.25 | Professional | 52 · Reduced service | $91.20 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $56.23 | Professional | 53 · Discontinued | $36.31 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $154.88 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.90 Typical High $42.66 | Professional | 55 · Aftercare only | $27.54 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.20 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $144.54 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $128.82 | $144.54 | $199.53 |
Where Indiana sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 42nd of 51
$251
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.