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 $457.09 Median $1,380.38 Typical High $5,011.87 | Facility | None | $457.09 | $1,380.38 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $660.69 | Professional | None | $457.09 | $575.44 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,309.57 | Facility | None | $741.31 | $3,235.94 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $724.44 Typical High $891.25 | Professional | None | $407.38 | $724.44 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $501.19 | Facility | None | $257.04 | $257.04 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $1,479.11 | Facility | None | $154.88 | $257.04 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,548.82 | Professional | None | $512.86 | $724.44 | $1,548.82 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $234.42 Median $457.09 Typical High $2,089.30 | Facility | None | $234.42 | $457.09 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $1,380.38 | Professional | None | $562.34 | $891.25 | $1,380.38 |
United Setting Facility Modifier None Typical Low $109.65 Median $812.83 Typical High $4,168.69 | Facility | None | $109.65 | $812.83 | $4,168.69 |
United Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $1,148.15 | Professional | None | $457.09 | $676.08 | $1,148.15 |
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 $229.09 Median $281.84 Typical High $331.13 | Professional | 52 · Reduced service | $229.09 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $112.20 Typical High $131.83 | Professional | 53 · Discontinued | $91.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $426.58 Typical High $489.78 | Professional | 54 · Surgery only | $346.74 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $85.11 Typical High $100.00 | Professional | 55 · Aftercare only | $69.18 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $56.23 Typical High $66.07 | Professional | 56 · Pre-op care only | $45.71 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $398.11 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $323.59 | $398.11 | $457.09 |
Where Indiana sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 33rd of 51
$708
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.