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 $602.56 Median $4,786.30 Typical High $17,782.79 | Facility | None | $602.56 | $4,786.30 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $794.33 | Professional | None | $602.56 | $660.69 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $5,370.32 Typical High $9,549.93 | Facility | None | $1,513.56 | $5,370.32 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $870.96 | Professional | None | $524.81 | $660.69 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $1,348.96 | Facility | None | $645.65 | $645.65 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,230.27 Typical High $2,570.40 | Facility | None | $758.58 | $1,230.27 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,584.89 | Professional | None | $645.65 | $812.83 | $1,584.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $2,290.87 | Facility | None | $1,000.00 | $1,659.59 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,584.89 | Professional | None | $691.83 | $1,071.52 | $1,584.89 |
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 $549.54 Median $741.31 Typical High $1,288.25 | Professional | None | $549.54 | $741.31 | $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 $302.00 Median $331.13 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $134.90 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $602.56 | Professional | 54 · Surgery only | $446.68 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $562.34 |
Where Indiana sits
The same service costs 5.6 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· 42nd of 51
$741
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.