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 $309.03 Median $3,467.37 Typical High $11,220.18 | Facility | None | $309.03 | $3,467.37 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $446.68 | Professional | None | $309.03 | $363.08 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $5,248.07 Typical High $9,549.93 | Facility | None | $891.25 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $416.87 | Professional | None | $257.04 | $316.23 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $467.74 Typical High $616.60 | Professional | 50 · Both sides | $389.05 | $467.74 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $2,884.03 | Facility | None | $331.13 | $331.13 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,778.28 Typical High $3,162.28 | Facility | None | $446.68 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $724.44 | Professional | None | $288.40 | $416.87 | $724.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $891.25 Median $2,630.27 Typical High $6,025.60 | Facility | None | $891.25 | $2,630.27 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $354.81 Median $588.84 Typical High $851.14 | Professional | None | $354.81 | $588.84 | $851.14 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $676.08 | Professional | None | $281.84 | $398.11 | $676.08 |
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 $154.88 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $154.88 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $72.44 Typical High $89.13 | Professional | 53 · Discontinued | $61.66 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $269.15 Typical High $331.13 | Professional | 54 · Surgery only | $234.42 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $53.70 Typical High $67.61 | Professional | 55 · Aftercare only | $46.77 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.90 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $251.19 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $218.78 | $251.19 | $309.03 |
Where Indiana sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 47th of 51
$372
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.