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 $524.81 Median $741.31 Typical High $8,128.31 | Facility | None | $524.81 | $741.31 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $794.33 | Professional | None | $467.74 | $588.84 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $912.01 | Professional | None | $457.09 | $588.84 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $2,041.74 | Facility | None | $575.44 | $575.44 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,737.80 Typical High $2,691.53 | Facility | None | $630.96 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,000.00 | Professional | None | $467.74 | $691.83 | $1,000.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $3,090.30 | Facility | None | $1,023.29 | $2,137.96 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,202.26 | Professional | None | $489.78 | $776.25 | $1,202.26 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,949.84 Typical High $4,677.35 | Facility | None | $512.86 | $1,949.84 | $4,677.35 |
United Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,047.13 | Professional | None | $478.63 | $660.69 | $1,047.13 |
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 $234.42 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $234.42 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $93.33 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $354.81 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $87.10 Typical High $97.72 | Professional | 55 · Aftercare only | $70.79 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $46.77 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $331.13 | $407.38 | $457.09 |
Where Indiana sits
The same service costs 4.3 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· 38th of 51
$676
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.