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 $537.03 Median $3,467.37 Typical High $11,220.18 | Facility | None | $537.03 | $3,467.37 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $831.76 | Professional | None | $537.03 | $645.65 | $831.76 |
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 $549.54 Median $691.83 Typical High $1,071.52 | Professional | None | $549.54 | $691.83 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $2,041.74 | Facility | None | $660.69 | $660.69 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,445.44 Typical High $2,691.53 | Facility | None | $630.96 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,096.48 | Professional | None | $549.54 | $776.25 | $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 $537.03 Median $870.96 Typical High $1,348.96 | Professional | None | $537.03 | $870.96 | $1,348.96 |
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 $549.54 Median $758.58 Typical High $1,202.26 | Professional | None | $549.54 | $758.58 | $1,202.26 |
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 $269.15 Median $323.59 Typical High $363.08 | Professional | 52 · Reduced service | $269.15 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $107.15 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $549.54 | Professional | 54 · Surgery only | $407.38 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $109.65 | Professional | 55 · Aftercare only | $81.28 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $72.44 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $380.19 | $457.09 | $512.86 |
Where Indiana sits
The same service costs 4.5 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· 35th of 51
$776
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.