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 $741.31 Median $5,011.87 Typical High $11,220.18 | Facility | None | $741.31 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,348.96 | Professional | None | $707.95 | $891.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,348.96 Typical High $1,995.26 | Professional | 50 · Both sides | $1,071.52 | $1,348.96 | $1,995.26 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $2,511.89 | Facility | None | $912.01 | $912.01 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,584.89 Typical High $2,691.53 | Facility | None | $645.65 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,348.96 | Professional | None | $588.84 | $912.01 | $1,348.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $4,168.69 | Facility | None | $1,174.90 | $2,570.40 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,548.82 | Professional | None | $741.31 | $1,122.02 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,445.44 | Professional | None | $691.83 | $891.25 | $1,445.44 |
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 $371.54 Median $371.54 Typical High $457.09 | Professional | 52 · Reduced service | $371.54 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $630.96 |
Where Indiana sits
The same service costs 7.6 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· 39th of 51
$933
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.