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 $588.84 Median $5,011.87 Typical High $7,244.36 | Facility | None | $588.84 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $812.83 | Professional | None | $588.84 | $724.44 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $7,762.47 Typical High $17,378.01 | Facility | None | $1,122.02 | $7,762.47 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,096.48 | Professional | None | $588.84 | $691.83 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,511.89 | Facility | None | $724.44 | $724.44 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $2,691.53 | Facility | None | $630.96 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,258.93 | Professional | None | $602.56 | $831.76 | $1,258.93 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $4,168.69 | Facility | None | $954.99 | $2,630.27 | $4,168.69 |
Physicians Health Plan of Northern Indiana 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 |
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 $588.84 Median $812.83 Typical High $1,288.25 | Professional | None | $588.84 | $812.83 | $1,288.25 |
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 $295.12 Median $363.08 Typical High $407.38 | Professional | 52 · Reduced service | $295.12 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $117.49 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $446.68 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $89.13 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $58.88 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $416.87 | $501.19 | $575.44 |
Where Indiana sits
The same service costs 4.9 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· 43rd 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.