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 $776.25 Median $5,011.87 Typical High $11,220.18 | Facility | None | $776.25 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,047.13 | Professional | None | $776.25 | $776.25 | $1,047.13 |
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 $724.44 Median $912.01 Typical High $1,412.54 | Professional | None | $724.44 | $912.01 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $2,511.89 | Facility | None | $954.99 | $954.99 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $2,691.53 | Facility | None | $630.96 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,479.11 | Professional | None | $602.56 | $954.99 | $1,479.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $2,570.40 Typical High $4,168.69 | Facility | None | $954.99 | $2,570.40 | $4,168.69 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,621.81 | Professional | None | $776.25 | $1,174.90 | $1,621.81 |
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 $724.44 Median $933.25 Typical High $1,548.82 | Professional | None | $724.44 | $933.25 | $1,548.82 |
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 $389.05 Median $389.05 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $389.05 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $660.69 |
Where Indiana sits
The same service costs 7.1 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
$977
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.