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 $831.76 Median $5,011.87 Typical High $14,125.38 | Facility | None | $831.76 | $5,011.87 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | None | $831.76 | $831.76 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,513.56 | Professional | None | $794.33 | $1,071.52 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $676.08 Typical High $1,023.29 | Professional | 62 · Two surgeons | $512.86 | $676.08 | $1,023.29 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $4,073.80 | Facility | None | $1,023.29 | $1,023.29 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,238.72 Typical High $4,073.80 | Facility | None | $794.33 | $2,238.72 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,621.81 | Professional | None | $891.25 | $1,071.52 | $1,621.81 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,023.29 Median $4,168.69 Typical High $5,248.07 | Facility | None | $1,023.29 | $4,168.69 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,737.80 | Professional | None | $891.25 | $1,288.25 | $1,737.80 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,584.89 | Professional | None | $776.25 | $1,000.00 | $1,584.89 |
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 $416.87 Median $416.87 Typical High $512.86 | Professional | 52 · Reduced service | $416.87 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $204.17 | Professional | 53 · Discontinued | $165.96 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $102.33 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $724.44 |
Where Indiana sits
The same service costs 8.3 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
$1,096
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.