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 $645.65 Median $1,380.38 Typical High $7,244.36 | Facility | None | $645.65 | $1,380.38 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $912.01 | Professional | None | $501.19 | $645.65 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $630.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,000.00 | Professional | None | $512.86 | $660.69 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $2,041.74 | Facility | None | $616.60 | $616.60 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,659.59 Typical High $2,454.71 | Facility | None | $549.54 | $1,659.59 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,096.48 | Professional | None | $562.34 | $758.58 | $1,096.48 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,023.29 Median $2,187.76 Typical High $3,090.30 | Facility | None | $1,023.29 | $2,187.76 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,318.26 | Professional | None | $588.84 | $870.96 | $1,318.26 |
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 $524.81 Median $724.44 Typical High $1,148.15 | Professional | None | $524.81 | $724.44 | $1,148.15 |
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 $251.19 Median $316.23 Typical High $354.81 | Professional | 52 · Reduced service | $251.19 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $100.00 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $478.63 Typical High $537.03 | Professional | 54 · Surgery only | $380.19 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $95.50 Typical High $107.15 | Professional | 55 · Aftercare only | $75.86 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $63.10 Typical High $70.79 | Professional | 56 · Pre-op care only | $50.12 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $354.81 | $446.68 | $501.19 |
Where Indiana sits
The same service costs 4.2 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
$741
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.