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 $512.86 Median $3,548.13 Typical High $14,125.38 | Facility | None | $512.86 | $3,548.13 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $630.96 | Professional | None | $512.86 | $562.34 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,174.90 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $741.31 | Professional | None | $478.63 | $562.34 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $2,884.03 | Facility | None | $549.54 | $549.54 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,778.28 Typical High $3,311.31 | Facility | None | $676.08 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,288.25 | Professional | None | $489.78 | $691.83 | $1,288.25 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $6,025.60 | Facility | None | $1,348.96 | $2,454.71 | $6,025.60 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,288.25 | Professional | None | $588.84 | $870.96 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,174.90 | Professional | None | $501.19 | $660.69 | $1,174.90 |
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 $257.04 Median $269.15 Typical High $316.23 | Professional | 52 · Reduced service | $257.04 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $125.89 | Professional | 53 · Discontinued | $102.33 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $398.11 Typical High $467.74 | Professional | 54 · Surgery only | $389.05 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $79.43 Typical High $93.33 | Professional | 55 · Aftercare only | $77.62 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $63.10 | Professional | 56 · Pre-op care only | $51.29 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $371.54 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $363.08 | $371.54 | $436.52 |
Where Indiana sits
The same service costs 6.5 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· 45th of 51
$617
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.